AllAfrica, 14 May 2014
As part of efforts to prevent new infections and curb the further spread of the disease, the federal government has released a new National HIV/AIDS Prevention Plan.
The policy stipulates compulsory HIV test before marriage for both Muslims and Christians in the country. The Director of the Bauchi State Agency for the Control of HIV/AIDS, TB; leprosy and malaria, Dr Yakubu Abubakar, who revealed the existence of the new drive at a National prevention Plan Validation meeting in Abuja, noted that there were variations from state to state in the rate of prevalence, mode of transmission at state level, and the approach to HIV prevention. Abubakar did not provide details of how the new policy would be implemented.
The Chief Programme Officer in charge of Prevention, Social and Behaviour Change Communication at the National Agency for the Control of AIDS, Mrs Uduak Daniel, said that the difference between the last prevention plan and the recent one was that the new one had the participation of the people in local communities.
However, concerns have been raised regarding the legal and social implications of compulsion in medical health provision, even for a worldwide public health emergency that HIV/AIDS has become. Public health measures are important, but decreeing HIV test as requirement in a marriage contract between two consenting adults would amount to intrusion by the state in a purely private matter. Some arguments have already been canvassed that making the test mandatory would infringe upon the citizens' right to such privacy. Others take the view that a policy of general application like this one could adversely affect HIV control programme because it could intensify the fear of stigmatization.
In itself, the policy may be a good strategy to curb the spread of the deadly disease. But it will require legislation to back its successful implementation. However, caution is needed in drafting such a law, given the multi-faith nature and cultural diversity of the Nigerian society, all of which must be taken into account. It should also be preceded by strategic advocacy programmes to educate the most vulnerable target of the population on the desirability and goals of testing before marriage. Policies of this kind stand a better chance of succeeding when they are applied through persuasion.
Apart from just HIV test, the government should encourage would-be couples, through community-based enlightenment programmes, to undergo comprehensive medical check-ups that include a range of tests for diabetes, haemophilia, etc.
In July 2013, Nigeria hosted the Special Summit of the African Union (AU) on the HIV/AIDS, Tuberculosis and Malaria (ATM). The Declaration signed at the end of the Summit by Heads and Government of the AU noted some critical challenges that continue to militate against the elimination of the diseases. The Declaration expressed concern that the eradication of the scourge was threatened by the significant shortfall in financing the services aimed at strengthening health systems and reducing the prevalence among member states. Poverty and conflicts in member countries including Nigeria similarly continue to hamper preventive programmes; limiting access to health services.
The new government policy should factor in such disincentives and provide a comprehensive platform to make the compulsory test at the expense of the state, at least at this initial stage to encourage turnouts.
Abstinence by unmarried persons should be at the centre of public enlightenment campaigns. To successfully reduce the number of HIV infections towards the AU goal of zero new infection by 2030, the government should accelerate HIV programmes using a combination of effective evidence-based prevention particularly for young people and other vulnerable populations. As the Summiteers pledged in the Abuja Declaration of 2013, Nigeria like other member states needs to increase access of infected persons to anti-retroviral (ARV) therapy. The long-term goal should be to intensify research aimed at finding a curative vaccine.
Source: AllAfrica
