US embassy cable - 05LAGOS1047

UNCLAS SECTION 01 OF 02 LAGOS 001047 
 
SIPDIS 
 
UNCLASSIFIED 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: SOCI, KHIV, PGOV, NI 
SUBJECT: UPDATE ON LAGOS STATE AIDS CONTROL AGENCY 
EFFORTS 
 
 
1.  Summary:  Lagos State AIDS Control Agency (LSACA) 
continues to work with 11 state ministries, 20 local 
governments, and over 400 organizations to reduce the 
incidence and mitigate the impact of HIV/AIDS in Lagos 
State.  Achievements in 2004 included the expansion of 
voluntary counseling and testing (VCT) centers at 13 
public medical facilities and establishment of local 
AIDS control agencies in all local government areas. 
LSACA Chief Executive Officer Dr. Aderemi Desalu 
believes it is time to move beyond addressing stigma 
and focus on increasing personal responsibility for 
being tested and taking appropriate action.  In 2005, 
LSACA, with its partners, will develop its next five- 
year plan.  The agency also will push for a state 
HIV/AIDS bill and will explore adding anti-retroviral 
treatment to the services provided by VCT centers.  End 
summary. 
 
2.  LSACA continues to work with 11 state ministries, 
20 local governments, and over 400 organizations to 
fight HIV/AIDS in Lagos.  Eight work groups support 
agency staff in coordinating activities: information, 
education and communication; voluntary counseling and 
testing; primary care and support; blood and blood 
safety; justice and human rights; youth; resource 
mobilization; and monitoring and evaluation.  LSACA's 
primary international partners are Family Health 
International (FHI), the World Bank, UNICEF, ActionAid, 
and the Society for Family Health (SFH). 
 
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2004 Achievments: VCT Scale-Up and 
Local Agency Establishment 
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3.  In 2004, LSACA made progress in several areas. 
With support from USAID and in collaboration with FHI, 
the agency conducted sensitization workshops for the 
eleven collaborating state ministries and for local 
government staffs.  The Lagos State Ministry of Health, 
FHI, and LSACA collaborated to improve voluntary 
counseling and testing (VCT) centers at 13 public 
hospitals and health centers.  LSACA worked with local 
governments to establish a local AIDS control agency 
(LACA) in the 20 local government areas in the state. 
Collaboration with the World Bank focused on civil 
society organizations (CSOs), including training 450 
staff members of CSOs in community mobilization, 
proposal and report writing, financial reporting, and 
monitoring and evaluation.  UNICEF efforts focused on 
prevention of mother-to-child transmission programs in 
three hospitals, while ActionAid and SFH engaged in a 
range of activities from policy workshops to condom 
distribution.  Working with the Lagos State Traditional 
Medicines Board, LSACA trained 250 traditional medicine 
practitioners and 60 traditional birth attendants. (In 
addition to FHI and SFH, the USG also funds Hope 
Worldwide, Community Participation for Action in the 
Social Sciences (COMPASS), and the Nigerian Business 
Community Against AIDS(NIBUCAA) through USAID; StopAIDS 
through CDC, and SMARTWork through the Department of 
Labor.  All of these partners are collaborating to 
provide HIV/AIDS services under the Emergency Plan in 
Lagos State with the direction of LSACA.) 
 
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Result of Efforts: Reduced Stigma 
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4.  Now in the final year of LSACA's first five-year 
plan (2000-2005), Desalu claimed "amazing change" in 
awareness and stigma since LSACA's inception.  LSACA 
reported over 90 percent of Lagos residents are now 
aware of HIV/AIDS, compared to under 40 percent in 
2000.  As an example of decreased stigma, Desalu noted 
that five years ago, people living with HIV/AIDS would 
cover their faces in public interviews; now a network 
of people living with HIV/AIDS exists to openly combat 
discrimination.  Other progress Desalu noted was 
passage of a law making it an offense to transfuse 
unscreened blood and the six-fold reduction in the cost 
of anti-retroviral treatment (ART) during this five- 
year span, with hopes of a further drop to N1000 
($7.50) per month in 2005. 
 
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Next Hurdle: "Personal Conviction" 
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5.  Believing that Lagos is largely beyond the problem 
of stigma, Desalu said significant work remains to be 
done in regard to "personal conviction."   Lagos needs 
to progress to the point where individuals are 
concerned enough to be tested, confident that help is 
available, and aware that earlier diagnosis is better. 
Not discouraged by the still low level of use of VCT 
centers, Desalu said the key is to have the 
institutions and structures in place and continue 
spreading the message consistently that resources are 
available.  The basic message he seeks to spread is 
"you can know your HIV status; it's good to know your 
HIV status; here's where you can be tested; and if 
needed, here's where you can get help."  Desalu noted 
that progress has been made and continues in this area. 
He observed that five years ago, most people would 
question the value of knowing their HIV status; why be 
tested just to receive bad news? Then VCT centers 
emerged to provide some support and assistance, and now 
ART is becoming available, providing some hope and a 
reason to be tested. 
 
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Underway for 2005: Development 
of Next 5-Year Plan 
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6.  Many activities reported for 2004 are ongoing, but 
Desalu also noted several new and future efforts. 
LSACA is working with partners to develop the next five- 
year plan.  LSACA is pursuing "the three ones" 
approach: one plan, one coordination system, and one 
monitoring and evaluation system.  LSACA will soon 
complete a report on the use of VCT centers in the 
state, which will also include information on 
prevalence rates observed at the centers.  Efforts of 
the Justice and Human Rights Work Group currently focus 
on working with the Lagos House of Assembly and 
Ministry of Justice to pass an HIV/AIDS bill.  As a 
possible new activity for 2005, Desalu said he would 
like to add ART to the services provided at VCT 
centers. 
 
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Comment 
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7.  Though significant progress in fighting stigma has 
been made and more people living with HIV/AIDS are open 
about their status, stigma remains a significant 
problem in Lagos State.  In the workplace, in 
particular, few people with HIV/AIDS are open about 
their status for fear of discrimination.  However, as 
stigma-fighting efforts continue, the state will 
benefit from LSACA's focus on other areas.