Health
AU Endorses Initiatives to End AIDS by 2030
By Dipo Olowookere
African heads of state have endorsed two major new initiatives to help end AIDS by 2030. The community health workers initiative aims to recruit, train and deploy 2 million community health workers across Africa by 2020.
The western and central Africa catch-up plan aims to rapidly accelerate access to HIV treatment in the region and close the gap in access between African regions. The initiatives were endorsed at the AIDS Watch Africa Heads of State and Government Meeting, held on 3 July during the 29th African Union Summit in Addis Ababa, Ethiopia.
Western and central Africa catch-up plan
Under the leadership of countries and regional economic communities, and in collaboration with UNAIDS, the World Health Organization, Doctors Without Borders and other partners, the catch-up plan in western and central Africa, which started implementation in late 2016, seeks to dramatically accelerate the scale-up of HIV testing, prevention and treatment programmes, with the goal of putting the region on the Fast-Track to meet the 90–90–90 targets by December 2020.
While the world witnesses significant progress in responding to HIV, with 57% of all people living with HIV knowing their HIV status, 46% of all people living with HIV accessing treatment and 38% of all people living with HIV virally suppressed in 2015, the western and central Africa region lags behind, achieving only 36%, 28% and 12%, respectively, in 2015. The gap is considerable: 4.7 million people living with HIV are not receiving treatment, and 330 000 adults and children died from AIDS-related illnesses in 2015.
“We cannot accept a two-speed approach to ending AIDS in Africa,” said UNAIDS Executive Director Michel Sidibé. “To put western and central Africa on track to end AIDS, we must address stigma, discrimination and other challenges to an effective response, allocate funding to support the most effective strategies and implement delivery strategies that reach the communities most in need.”
The catch-up plan will aim to increase the number of people on treatment from 1.8 million to 2.9 million by mid-2018, giving an additional 1.2 million people, including 120 000 children, access to urgently needed treatment.
The first call for a catch-up plan for the region was made at the United Nations General Assembly High-Level Meeting on Ending AIDS in June 2016. Since then, at least 10 countries (Benin, Cameroon, the Central African Republic, Côte d’Ivoire, the Democratic Republic of the Congo, Guinea, Liberia, Nigeria, Senegal and Sierra Leone) have developed country operational plans deriving from the western and central Africa catch-up plan with a focus on ensuring the needed policy and structural changes.
Two million community health workers
The community health worker initiative aims to accelerate progress towards achieving the 90–90–90 targets by 2020—whereby 90% of all people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads—and to lay the foundation for sustainable health systems. Championed by the President of Guinea and African Union Chair, Alpha Condé, the initiative seeks to confront the acute health workforce shortages across Africa and improve access to health services for the most marginalized populations, including people living in rural areas.
“Recruiting 2 million community health workers is a critical step towards achievement of the Africa-wide socioeconomic transformation envisioned in the African Union’s Agenda 63”, said Mr Condé. “Few tools have the ability of community health workers to drive progress across the entire breadth of the 2030 Agenda for Sustainable Development.”
Substantial evidence, from both Africa and elsewhere, demonstrates that well-trained, properly supervised community health workers provide an excellent quality of care and improve the efficiency and impact of health spending. Community health workers have helped devise some of the most effective service delivery strategies for HIV testing and treatment, and studies have also linked community-delivered services with increased rates of immunization, exclusive breastfeeding and malaria control coverage.
“Sustainable community health work is a matter of survival and development in Ethiopia, said Prime Minister of Ethiopia Hailemariam Desalegn. “My community health workers have made better health happen. Achieving universal health coverage is not possible without building community health systems.”
UNAIDS estimates that there are more than 1 million community health workers in Africa today, but most focus on a single health problem and are under-trained, unpaid or under-paid, and not well integrated in health systems. The new initiative endorsed by AIDS Watch Africa seeks to retrain existing community health workers, where feasible, and to recruit new health workers to reach the 2 million target.
“Few investments generate such a remarkable social and economic return as community health workers,” said Jeffrey Sachs, Director, Earth Institute, Columbia University. “Community health worker programmes are essentially self-sustaining, in that they avert illness, keep workers healthy and productive and contribute to economic growth and opportunity.”
While community health workers may hold the key in many settings to achieving the 90–90–90 targets, the benefits of this new initiative extend well beyond the AIDS response. The initiative will expedite gains across the health targets of Sustainable Development Goal 3, create new jobs that will strengthen local and national economies and offer new opportunities to young people. The new initiative is aligned with the World Health Organization’s Global Strategy on Human Resources for Health.
Start Free Stay Free AIDS Free
At the AIDS Watch Africa meeting, the participants also called on member states and development partners to support the African Union campaign to eliminate new HIV infections among children and keep mothers alive as part of the Start Free Stay Free AIDS Free collaborative framework.
“Complacency gives birth to regression of the gains made in reducing HIV prevalence, said, Yoweri Museveni, President of Uganda. “We in Uganda have rekindled the campaign to end AIDS; the science exists, as well as the medication. We can win this battle.”
By Adedapo Adesanya
The National Health Insurance Authority (NHIA) says the number of Nigerians enrolled in health insurance has risen to more than 22 million.
The Director-General of NHIA, Mr Kelechi Ohiri, said this resulted from the implementation of the mandatory health insurance, which has gained momentum nationwide.
He said this on Wednesday at the Annual General Meeting of the Nigerian Association of Insurance and Pension Editors (NAIPE) in Lagos.
Mr Ohiri said enrolment had increased to 22.03 million, representing a 35 per cent year-on-year growth, attributing this to stronger collaboration with state social health insurance agencies, ministries, departments and agencies, organised labour, employers, the private sector, and the gradual implementation of the mandatory health insurance provisions of the NHIA Act.
He said that the country had moved beyond policy formulation to delivering measurable improvements in healthcare access, service quality and consumer protection in line with the federal government’s health sector reform agenda.
According to him, Nigeria already has the necessary policies and legislation to achieve Universal Health Coverage, positing that the key challenge was effective implementation.
“The decisive variable is now implementation- consistent, rigorous and accountable execution that converts political commitment into healthcare access for real Nigerians,” he said.
Mr Ohiri said that the transition from the former National Health Insurance Scheme to the NHIA had strengthened regulation, consumer protection, accountability and strategic purchasing, while providing the legal and operational framework for achieving Universal Health Coverage.
He added that improving the experience of enrollees remained central to the Authority’s reform agenda.
According to him, NHIA has strengthened its complaints management system, introduced faster resolution timelines, and intensified compliance monitoring of Health Maintenance Organisations (HMOs) and healthcare providers.
He further added that NHIA had sanctioned facilities that failed to meet the required standards, adding that his organisation had resolved 3,878 complaints, representing an 87 per cent resolution rate, while 95 per cent of the cases were concluded within prescribed timelines.
Mr Ohiri noted that more than N14.2 million had been refunded to enrollees, while non-compliant healthcare facilities had been sanctioned.
He said NHIA had also introduced service standards, including a one-hour treatment commencement target for enrollees requiring urgent care, to improve access to timely and quality healthcare services.
The NHIA boss further disclosed that capitation payments to healthcare providers had been increased by 93 per cent.
He said fee-for-service reimbursements rose by 378 per cent to enable providers to invest more in personnel, equipment and infrastructure.
According to him, 7,592 healthcare facilities have been assessed under the SafeCare quality framework as part of efforts to institutionalise continuous quality improvement across the country.
Mr Ohiri also highlighted interventions targeted at vulnerable groups, including support for more than 48,500 pregnant women, expanded maternal and newborn healthcare services, the Vulnerable Group Fund, and improved access to healthcare for pensioners and retirees.
He said Universal Health Coverage could only be achieved if every Nigerian, regardless of income or location, had access to quality healthcare services.
By Modupe Gbadeyanka
The new one-hour authorisation response time ultimatum policy introduced by the National Health Insurance Authority (NHIA) has received the full backing of SUNU Health Nigeria Limited.
This policy was introduced by the agency to ensure enrollees get prompt approval codes to access care.
Healthcare service providers have been urged to report any Health Maintenance Organisation (HMO) that violates this initiative through an email, with the HMO in copy and a timestamp attached as evidence of the request. They may proceed to offer services to enrollees thereafter.
Speaking at the company’s second-quarter Providers’ Forum for the Lagos-Ogun region in Lagos recently, the chief executive of SUNU Health, Dr Moyosore Olomola, expressed optimism that this policy would improve healthcare delivery in the country, especially for enrollees, who crave quality service.
At the event themed Improving Quality and Access to Care Through Stronger Provider Network, and held at the Nigerian Institute of Medical Research (NIMR) in Yaba, Lagos, Mr Olomola reaffirmed the HMO’s commitment to operating within legal and operational frameworks to guarantee adequate care for enrollees.
“Access to care and quality of care remain key priorities in our healthcare systems. We know quite well that deliberate collaboration, strategic partnerships, and a shared commitment to excellence are required to achieve these priorities.
“A strong provider network is doubtless the backbone of any effective healthcare system. It ensures that our mutual enrollees receive the right care, at the right time, in the right place, and at the right price,” Mr Olomola, represented at the programme by the organisation’s Chief Operating Officer (COO), Dr Faith Nwachi, stated.
He further assured that SUNU Health would strictly adhere to the one-hour authorisation limit, stressing that this aligns seamlessly with one of the organisation’s core values—promptness and its corporate slogan, Humanity is the centre of our initiatives.
In a bid to further improve access and quality of care, SUNU Health also demonstrated its new operational software and Mobile app, aptly named SUNU Legacy.
Also speaking at the event, the NHIA Lagos State Coordinator (Ikeja), Dr Bethuel-Kasimu Abraham, noted that the forum’s expected outcome is to significantly reduce delays in accessing medical care.
Other key expectations include ensuring continuity of care, improving patient outcomes, and strengthening accountability among HMOs.
Addressing specific pain points faced by enrollees, the NHIA Ogun State Coordinator, Mr Dare Adefeso, acknowledged that the agency had received complaints regarding out-of-stock drugs and the discrimination of enrollees by certain providers.
He affirmed that the NHIA is actively addressing these issues, stressing that moving forward, every facility must ensure enrollees are properly catered to regardless of their status, provided they have an active health insurance plan.
Corroborating the long-standing legacy of SUNU Health, the Ogun State Director of the National Orientation Agency (NOA), Mrs Aishat Tiamiyu, shared that her agency is responsible for public information dissemination and has been enrolled with SUNU Health for over 25 years.
Commending the HMO’s stellar service over two decades, she called for the immediate enrollment of new NOA staff into the scheme.
The Providers’ Forum remains one of the strategic channels employed by SUNU Health to consistently engage healthcare providers, understand their operational challenges, introduce new software updates, and solidify partnerships aimed at fostering premium healthcare delivery across Nigeria.
By Aduragbemi Omiyale
The National Agency for Food and Drug Administration and Control (NAFDAC) has announced the recall of a sexual enhancement product known as WAP Sensual Enhancement Capsules.
In a statement on Monday, the Nigerian agency disclosed that the recall is due to “undeclared pharmaceutical ingredients” in the product, whose country of origin is unknown, but is marketed and distributed online in the US through eBay.
It was emphasised that the recall is being “voluntarily” made by the manufacturer, Best Supplements Best Prices Company.
The detection of the undeclared pharmaceutical ingredients was made by the US Food and Drug Administration (FDA).
Laboratory analysis by the US FDA revealed that the product contained undeclared sildenafil, tadalafil, and flibanserin, which were not mentioned on the product label. Such substances may include phosphodiesterase type-5 (PDE-5) inhibitors or related compounds commonly used for the treatment of erectile dysfunction, the statement by NAFDAC stated.
Sildenafil and tadalafil are ingredients in FDA-approved prescription drugs used to treat erectile dysfunction.
It was noted that these undeclared ingredients may interact with nitrates found in some prescription drugs, such as nitroglycerin, and may lower blood pressure to dangerous levels. Consumers with diabetes, high blood pressure, high cholesterol, or heart disease often take nitrates.
Flibanserin is the active ingredient in an FDA-approved prescription drug used to treat low sexual desire in women. Flibanserin can cause drowsiness, sedation, dangerously low blood pressure, and fainting, especially when combined with alcohol.
Consumers have been encouraged to report compromised products (medicines or medical devices) to the nearest NAFDAC office, call 0800-162-3322, or send an email to sf******@********ov.ng.
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