US embassy cable - 05ABUJA1610

UNCLAS SECTION 01 OF 03 ABUJA 001610 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: KHIV, SOCI, TBIO, ECON, PREL, PGOV, NI, HIV/AIDS 
SUBJECT: THE STATE OF HIV/AIDS IN NIGERIA AS OF JUNE 2005 
 
REF:  ABUJA 209 
 
1. Summary:  This cable evaluates broadly HIV/AIDS' impact 
on Nigerians and their institutions.  Roughly 4 million 
(UNAIDS, 2003) of the nation's 130 million people (PRB, 
2002) are infected with HIV/AIDS, reflecting a national 
HIV/AIDS infection rate of 5 percent (NPS, 2003).   Nigeria 
had at least 2.4 million HIV-positive workers in 2003. (ILO, 
2004)  Although senior Nigerian officials are committed to 
combating HIV/AIDS, the sense of urgency to do something 
about it diminishes increasingly down the Nigerian 
bureaucratic ladder.  HIV/AIDS has the potential to further 
destabilize Nigeria, where about 85 million Nigerians try to 
survive on less than USD 1 per day.  Most of Nigeria's 
economic activity occurs in the informal sector, which does 
not provide health and death benefits, so HIV/AIDS harms the 
poorest Nigerians disproportionately.  Because the GON 
nonetheless recognizes the threat and values its partnership 
with the United States, our common effort to combat HIV/AIDS 
is strengthening our bilateral relationship.  End summary. 
 
2. This is the second of Embassy Abuja's twice-yearly cables 
on the effects of HIV/AIDS on Nigerians and the Nigerian 
economy.  This cable seeks to evaluate broadly HIV/AIDS' 
impact on Nigeria's institutions and society.  Statistics on 
HIV and AIDS in Nigeria are fragmentary and not always up to 
date.  Nigeria's National HIV Sero-Prevalence Survey 
estimated the national rate of HIV/AIDS infection in 2003 to 
be 5 percent (NPS, 2003).  This 5-percent infection rate 
means roughly 4 million adults aged 15-49 (UNAIDS, 2003) of 
Nigeria's approximately 130 million citizens and residents 
(Population Reference Bureau, 2002) have HIV or AIDS.  In 
2003, 310,000 Nigerian adults and children died of AIDS. 
(IMF, "The Macroeconomics of HIV/AIDS," Nov. 2004)  Nigeria 
then had 7 million orphans - who comprised 10.1 percent of 
all its children - and that same year, it had 1.8 million 
AIDS orphans. (IMF, Nov. 2004)  Because of the increase of 
HIV and AIDS, UNICEF predicts Nigeria's orphans will 
increase rapidly to 8.2 million by 2010.  (UNICEF, 2005) 
 
3. Nigeria's youth bulge - 63 percent of its population is 
under age 25 (Nigeria Demographic and Health Survey, 2003) - 
makes the threat of HIV/AIDS very significant.  The 
country's highest prevalence of HIV, 5.6 percent, is found 
among its 20 to 24 age group.  (NPS, 2003)  Unless there is 
sustained action to target and protect this age group, a 
significantly larger wave of HIV/AIDS likely will result. 
In May 2005, Nigeria launched a new drive to improve the 
country's blood-bank system and help stem the spread of HIV 
through contaminated blood.   At that time, the director of 
the U.S. charity Safe Blood for Africa said roughly 10 
percent of 1 million samples of blood tested in Nigeria were 
contaminated with HIV.  (UN Office for the Coordination of 
Humanitarian Affairs, 2005) 
 
4. In terms of life expectancy, a Nigerian child born today 
can expect to live 49 years.  (DHS, 2003)  The IMF estimates 
that deaths of adults (ages 15 to 49) excluding AIDS will 
make up 17 percent of all deaths in Nigeria in 2005; the 
inclusion of Nigerian adults' deaths from AIDS will boost 
this figure to 27 percent of all deaths nationally. (IMF, 
Nov. 2004)  In demonstrating how harsh daily life is in 
Nigeria, the International Labor Organization (ILO) 
estimated in 2004 (based on a projected 2005 population of 
130 million) that fewer than 4.1 million of these persons 
would live to at least age 65 by this year. (ILO, "HIV/AIDS 
and Work," 2004)  (Comment:  This ILO population projection 
is about 10 million shy of our current estimate, which is 
based on data compiled by the Population Reference Bureau. 
End comment.) 
 
5. By the end of 2003, Nigeria had at least 2.4 million HIV- 
positive people aged 15 to 64 in its labor force - with 
"labor force" defined as all persons who are economically 
active, including all persons of working age who are in paid 
employment, gainful self-employment, or unemployed but 
available for and seeking work. (ILO, 2004)  The ILO 
estimates that Nigerians who will have died from AIDS during 
1995 to 2005 will equal 3 percent of the cumulative total of 
Nigeria's labor force during that decade. (ILO, 2004) 
Because most of Nigeria's economic activity occurs in the 
informal sector, which does not provide health and death 
benefits, HIV/AIDS harms the poorest Nigerians 
disproportionately in economic terms. 
 
6. HIV/AIDS has the potential to further destabilize 
Nigeria, where the governmental and services infrastructures 
already have broken down and where about 85 million 
Nigerians try to survive on less than USD 1 per day. 
HIV/AIDS also poses a significant threat particularly to 
Nigeria's urban elite, who because of their mobility and 
behavior are more likely to be infected.  The urban elite 
also are relatively young, in their economic prime, and 
likely better educated than the average Nigerian.  The 
consequences of these shortened lives and careers include 
fewer persons becoming leaders in Nigeria's society and 
economy, declining productivity, greater costs of 
production, and decreased household income and opportunities 
for education. (IMF, Nov. 2004)  While it is difficult to 
quantify precisely HIV/AIDS' economic cost to Nigeria, the 
disease's effects include declines in Nigerian society's 
human capital and physical capital.  As spending is shifted 
toward HIV/AIDS-related activities, aggregate saving is 
likely to fall.  This leaves fewer resources for investment 
as higher production costs and deteriorating economic 
prospects make investing in Nigeria less attractive. (IMF, 
Nov. 2004) 
 
7. Senior Government of Nigeria (GON) officials are 
realistic about the threat HIV/AIDS poses.  President 
Obasanjo personally lent his support by speaking on World 
AIDS Day at the launch of the (U.S.) President's Emergency 
Plan for AIDS Relief, and there is strong Nigerian public 
support for the Emergency Plan.  Also, there is close 
coordination between the GON Ministries of Health and 
Defense and the U.S. Mission, including officials at USAID, 
the Department of Defense, and the Centers for Disease 
Control.  In addition, U.S. Ambassador Campbell and 
Nigeria's minister of health co-chair a biweekly steering 
committee on the issue of HIV/AIDS in Nigeria, while the 
Nigerian minister of state for defense has made HIV/AIDS 
prevention one of his priorities.  The Nigerian military's 
HIV prevalence rate is unknown but is estimated to be 
between 5 and 10 percent, according to several small studies 
conducted in recent years.  All potential recruits are 
tested for HIV before being accepted for service, but unlike 
the U.S. armed forces, the Nigerian military does not 
continue mandatory in-service HIV testing for its personnel. 
The Nigerian military is presently working on instituting 
anonymous mass testing of the military.  The Nigerian Air 
Force has mandatory HIV testing only for air crew members on 
flight status.  All military personnel seeking to serve 
outside Nigeria on peacekeeping operations must be tested 
for HIV, both before and after their deployment - but these 
test results generally are unavailable even to the Nigerian 
military's medical commands and to its Armed Forces Program 
on AIDS Control. 
 
8. Despite this commendable commitment at the senior level 
of the GON to combating HIV/AIDS in Nigeria, government 
personnel's awareness of the extent of this disease 
diminishes increasingly down the Nigerian bureaucratic 
ladder.  Nigerian officials occasionally express complacency 
over Nigeria's success in capping the nation's infection 
rate at "only" 5 percent - especially in comparison to other 
African countries' significantly higher rates.  Moreover, 
AIDS' serious threat to Nigeria is relatively abstract to 
the typical Nigerian in the street.  Many of Nigeria's 
institutions and a large percentage of Nigerian society 
still engage in widespread denial of the damage wreaked by 
the disease, in large part because of HIV/AIDS' stigma in 
Nigerian society.  Unlike in Uganda, where AIDS has been 
widespread, only 25 percent of Nigerians report knowing 
someone who has AIDS or who died from it. (Nigeria National 
HIV/AIDS and Reproductive Health Survey, 2003)  Partly 
because Nigeria has no network of morgues, Nigerians facing 
death from AIDS generally leave the city and return to their 
village.  These already weakened AIDS sufferers usually die 
first from malaria or tuberculosis (TB) and, most important, 
often are believed to have died from malaria or TB, not 
AIDS. 
 
9. In fiscal year (FY) 2005, U.S. Government (USG) funding 
in Nigeria for the President's Emergency Plan for AIDS 
Relief totaled nearly $90 million.  Under the Office of the 
U.S. Global AIDS Coordinator and Ambassador Campbell, five 
USG agencies work collaboratively, including with Nigerian 
and international entities, to implement the Emergency Plan 
through sustainable prevention, care, and treatment 
programs.  As of June 2005, the USG directly supported 
12,852 individuals on antiretroviral therapy (ART) in the 
nine focus states of Anambra, Borno, Cross-River, Edo, Kano, 
Lagos, Oyo, Plateau, and the Federal Capital Territory. 
Also as of June 2005, the USG was rapidly increasing the ART 
services its partners offer to meet its target of having 
36,222 individuals on ART by March 2006.  Currently, more 
than 400 USG-supported HIV-prevention programs target at- 
risk individuals.  In the first half of FY 2005, 
approximately 29,350 patients received basic health care and 
support at 40 USG-sponsored service outlets.  Finally, more 
than 30,000 clients have received counseling and testing in 
facilities supported by the Emergency Plan. 
 
10. The GON fully recognizes the threat of HIV/AIDS.  It 
values its partnership with the United States and U.S. 
cooperation on the HIV/AIDS issue.  Our partnership in 
combating HIV/AIDS is strengthening our bilateral 
relationship. 
 
11. This cable was reviewed by Embassy Abuja's Economic 
Section, its Office of Defense Cooperation, and by USAID 
Abuja. 
 
CAMPBELL