By Yusuf Alli, Managing Editor, Northern Operation, Frank Ikpefan and Tony Akowe, Abuja

• Don’t allow governors desecrate Nigerian constitution, former ACF scribe tells President

• CSO’s: Why Buhari must assent to bill

• NASS may not increase INEC budget for primaries

Following the dust being raised over the new Electoral Act now awaiting the assent of President Muhammadu Buhari, the Presidency said yesterday that the No.1 citizen was still consulting widely on whether or not to give his nod to the amended law.

Aso Rock Villa said there  was nothing to worry about concerning the President’s assent.

Some civil societies joined in making a case for Buhari to waste no further time in signing the bill into law while a former  Secretary General of the Arewa Consultative Forum (ACF), Mr. Anthony Sani, said the President should ignore the opposition of state governors to the bill and do the needful immediately.

The President has up till December 19th to append or decline his signature to the bill.

His  Senior Special Assistant on Media and Publicity, Mallam Garba Shehu,exclusively responding to an enquiry from The Nation clarified that the President has not declined assent to the electoral law.

“There is no truth in the story that President Muhammadu Buhari has declined signature on the bill,” Shehu said.

Continuing, he said:” He has not taken a decision yet. The President is widely consulting.

“I believe there is nothing to worry about. There is still time. I believe he still has up to December 19th or thereabouts.”

Former ACF scribe: Governors should not be allowed to desecrate constitution

Former Secretary General of the Arewa Consultative Forum (ACF), Anthony Sani,added his voice to the controversy  sparked by the bill.

He  asked President Muhammadu Buhari to stop the  state governors from alleged desecration of the constitution.

Sani in a statement in Abuja said President Buhari should not bow to pressure from the governors not to sign the electoral bill.

The governors are especially against the recommendation of direct primary as the mode of  picking candidates by the parties for elective offices.

The ex-ACF secretary  described   pressure from the governors on the President not to sign the bill  as self- serving and not in the interest of democracy and the Nigerian people.

“When people emphasize the notion that the state governors can upturn what the National Assembly has duly passed, they ignore the impression being conveyed that such a course of action cuts across the grain of our constitution which places responsibility for law making on the legislators,” Sani said.

He added:”Our governors should not be allowed to desecrate our constitution by acting as the de facto National Assembly.

“So far, the argument by the governors against direct primary is rather very weak and self- serving while that in favour of direct primary that makes it possible for all political party members to participate in the choice of their party candidates for elections, thereby eviscerating the roles of money bags (plutocracy), corrupt practices of buying delegates (kleptocracy) and imposition of candidates leading to improvement of  internal democracy, is much stronger and more democratic.

“Indirect primary confers undue advantage on incumbent governors who can manipulate delegates that include super delegates. Hence, the prevalent incidence of parallel congresses in many states. Direct primary would stop all that through involvement of all party members.

“As regards the costs of direct primary bandied about to scare Mr President from assenting the Electoral Amendment Bill, one wonders the wisdom. This is because direct primary is often at the level of polling units or at ward level where INEC staff are expected to witness.

“Any other level-be it State Assembly, House of Representatives, Senate or Governor constituencies are matters of collation. So, where is the humongous cost of direct primary coming from?

“We therefore appeal to Mr. President not to pander to the demand of the governors that is spurred not by desire to improve our practices of democracy but by a crass sense of narcissism. The President should assent the Bill for the larger interest of multiparty democracy and, thus, for national interest.”

Civil societies to Buhari: Sign Electoral Bill into law

Several Civil Society Organisations (CSOs) have  asked  President Muhammadu Buhari to sign the contentious Electoral Act Amendment Bill before him into law.

The bill, according to the CSOs, contains specific provisions aimed  at enhancing the quality and credibility of elections and address certain lacunas in the existing electoral legal framework.

The civil societies include: Yiaga Africa, International Press Centre (IPC), Centre for Citizens with Disability (CCD), Albino Foundation, CLEEN Foundation, Institute for Media and Society (IMS), Nigerian Women Trust Fund (NWTF) and Premium Times Centre for Investigative Journalism (PTCIJ).

They were of the opinion that the bill would  not only encourage increased citizens’ participation in the electoral process, but  will also enhance the capacity of the democratic institutions to improve the transparency and legitimacy of electoral outcomes.

Besides, they said the timely assent to the bill would  facilitate early preparations and efficient election administration of the 2023 general election, which is just 443 days away.

Read Also; Buhari should sign amended Electoral Act, says Wike

But they said that in the event of the President declining to sign the bill, the National Assembly should invoke its power by passing it into law as stipulated by the Constitution.

The CSOs said: “President Muhammadu Buhari must continue to pursue and honour his commitment to bequeath to Nigerians an electoral system that guarantees the conduct of credible, inclusive and peaceful elections.

“Further amendments to the Electoral Bill 2021 by the National Assembly should be undertaken in the next electoral cycle based on real and perceived lacuna identified in the implementation of the current Bill.”

Executive Director of Centre for Citizens and Disability, David Anyaele, said it was wrong for President Buhari to delay in assenting to a bill designed to encourage increased citizens’ participation in the electoral process just to please a small group of people that do not mean well  for the country.

He said: “The lawmakers were democratically elected to represent their people and they have prepared the bill in line with the yearnings and aspirations of their people. They must stand and defend the wish of the people who elected them into offices by vetoing the President should he return the bill to the house without assent.”

Executive Director of Yiaga Africa, Samson Itodo, said the civil societies were  in support of the President’s decision to invite comments from relevant Ministries, Departments and Agencies of government on the Bill, saying input from Chairman of INEC, Attorney-General of the Federation and Minister of Justice, Minister of the Interior, Minister of Finance and the Inspector General of the Police are probably the most crucial.

The National Assembly had transmitted the Bill to the President on November 19, following its passage.

The President has until December 19 to either sign or decline assent.

The Nation had earlier reported how senators and House of Representatives members had come under pressure from governors to review the Electoral Act and retain the indirect primary.

It was also learnt that the Presidency might seek a review of the Act, if the pressure persisted.

NASS may not increase INEC’s 2022 budget

The Nation also gathered  that the National Assembly may not increase the 2022 budget of the Independent National Electoral Commission (INEC) to monitor direct primary.

It was learnt that some senators and members of the House of Representatives agreed yesterday that there was no basis for additional funds for INEC for indirect and direct primaries.

A Senator, who attended a caucus meeting, said: “At our session, we looked at the provisions of the new Electoral Act again. There is no provision mandating INEC to conduct either Direct Primary.

“It is the business of each party to conduct its primary. INEC’s responsibility is to monitor compliance with the Electoral Act.

“We don’t understand where this issue of additional N500billion came from. This is why the House of Representatives has invited the Chairman of INEC, Prof. Mahmood Yakubu.

“The reality is that we believe INEC can monitor either direct or indirect primary with its 2022 budget. We resolved that there is no basis for increasing INEC’s budget.”

By Kofoworola Belo-Osagie and Gbenga Omokhunu, Abuja

• How my son was abused cultists, by father

• Lagos begins probe; school shut down indefinitely

A storm has broken out over the death of Sylvester Oromoni, a 12 year-old student of Dowen College, Lekki, Lagos on Tuesday.

While the family is alleging foul play, the school authorities claimed the boy got injured playing football.

Lagos State government has quickly stepped in by instituting a probe and shutting down the school indefinitely.

The incident is also drawing reactions from cross section of Nigerians.

Former Vice President, Atiku Abubakar, took to his verified twitter handle to demand justice for the deceased and his family. “We shall be failing in our duties as parents/guardians, administrators, security agencies and government if we do not get to the bottom of the case of late Sylvester Oromoni. It is beholden upon us to enthrone a safe environment in our schools. #Justiceforsylvester,”

Human Rights Writers Association of Nigeria (HURIWA) on Friday asked the Attorney General, Minister of Education and the Lagos State’s Attorney General and Education Commission to jointly conduct a transparent investigation on the unexplained death of the 12 year old student.

The Lagos State government on Friday  indefinitely shut down Dowen College following the controversy surrounding the death of  the student.

The closure followed  a visit by the Education Commissioner, Mrs Folasade Adefisayo, and other top officials of the Lagos State Ministry of Education to the school on Friday.

A statement by the Assistant Director, Public Affairs, Lagos State Ministry of Education, Mr. Ganiu Lawal, reads: “The Lagos State Government has ordered the indefinite closure of Dowen College, Lekki , pending the outcome of an investigation into  the death of Sylvester Oromoni Jnr, a student of the school.

Read Also; ‘Pupil’s death not cultism-related’

“Commissioner for Education, Mrs. Folasade Adefisayo, announced the closure after a meeting with the school management and staff.

“The commissioner called for calm,, saying no effort will be spared in getting to the root of the incident.”

The commissioner in an earlier statement commiserated with Sylvester’s family.

“Lagos State Government sends its condolences to the parents of 12-year-old Sylvester Oromoni Jnr.,a student of Dowen College, Lekki.

“The Commissioner for Education, Mrs. Folasade Adefisayo, notes that this incident is shocking and the state is indeed sad about this great loss.

“The state government is in touch with the parents in this difficult time.

“We reassure the family of the late Sylvester Oromoni Junior and Lagosians at large that efforts are being made to unravel the circumstances leading to his demise, even as we reiterate the government’s commitment to child protection.”

Management of Dowen College, it was learnt has  sent mails to all  parents and guardians of their students informing them  that the school would  not be shutting it’s learning processes completely. It said it would  be moving  online for safety and transparency.

Junior’s father, according to a report by TheCable, an online news medium, had planned to withdraw him from the school following reported cases of bullying in the past but reconsidered  his decision.

“My son suffered. His birthday is next tomorrow (Dec 4). I’ll celebrate it. I’ll have a cake baked. I’ll cut it on his behalf. The boys they mentioned were also reported to the school last term when they bullied Junior and collected all his foodstuffs; clothes. I have two daughters, one of whom earlier graduated. I had to remove the second after this incident. They asked this boy to describe the sister’s privates and this got to us.”

Oromoni’s family said Dowen had temporarily suspended the boys involved after the family’s eldest son took it up. He said Junior was also switched to a new hostel but the bullying and intimidation persisted into the new term.

“They put fear in him so much so that, when you ask him, he might keep to himself and say, ‘they will kill me’. This way, we didn’t know what to do. I considered removing him reconsidered since his sisters were still in the school. The new incident came to my knowledge on November 21st after the school called my wife to notify us that our son was in the school clinic, injured. My senior son, who was to make a London trip, came to see us in Warri,” he said.

“The next day, we sent a family friend to help pick up our son since he was the only person in Lagos and take him to the hospital. When he got there, he panicked, pointing out that he doubts it’s a football injury as the school claimed. He said the boy couldn’t stand because his waist was bent and swollen along with one side of his belly. His mouth was black. I asked, ‘is this really a football injury?’ He was taken to my house in Lagos but couldn’t sleep at night.

“I asked my eldest to fly to Lagos on November 24 while I took a trip to Asaba, from where I’d also make for Lagos. On getting there, he screamed. ‘This is beyond football injury. Come to Lagos now,’ he told me over the phone.”

Oromoni said the family flew the deceased to Warri where blood tests and an x-ray were conducted. He said Junior also underwent typhoid/malaria treatments but his mouth started peeling in excess of malaria drug side effects. The bereaved said the deceased only managed to sleep one hour when sedated and would wake up screaming in pain. The father added it was on November 29, when he was away for a government function, that Junior “opened up”.

Oromoni said Junior, before his death, revealed he neither played ball nor tripped as claimed. He also alleged that the deceased stated that five boys had barged into his room, put off the lights, and beat him up in the presence of other students.

“Junior said, ‘mummy, I didn’t play ball; I didn’t fall.’ He jumped off his hostel bed. They kicked him, matched his waist. Other students ran off. They threatened to kill them all if they spoke a word to the school staff. They warned Junior to say he sustained injuries while playing ball. They threatened him. If you ask the roommate, they’d all lie. They matched his ribs and waist. All that pain for a 12-year-old,” he said, trailing off into a soft sob over the phone.

By Yusuf Alli, Managing Editor, Northern Operation, Bolaji Ogundele, and Moses Emorinken, Abuja

• Expect more variants, NCDC warns Nigerians

• Federal tertiary institutions are prepared, say CMDs

The Federal Government on Friday approved the administration of COVID-19 booster doses for persons that have completed two doses of AstraZeneca, Moderna, Pfizer Bio-N-Tech or one dose of Johnson & Johnson.

This is coming after the country confirmed three cases of the highly transmissible Omicron COVID-19 variant, with risk of re-infection, according to the World Health Organization (WHO).

The Executive Director of the National Primary Health Care Development Agency (NPHCDA) Dr Faisal Shuaib, who made this known in a statement, disclosed that aside from being 18 years and above, eligible persons for the booster doses must have taken their second doses of AstraZeneca, Moderna or Pfizer Bio-N-Tech six (6) months before the booster doses.

Also, for those who have taken a single dose of Johnson & Johnson, there must be a two- month time interval before receiving the booster dose. Eligible persons for the booster doses are advised to visit the nearest health facility or mass vaccination site from December 10, 2021 across the country.

According to the statement signed by the Head of Public Relations Unit of the NPHCDA, Mohammad Ohitoto: “The Presidential Steering Committee in collaboration with the Federal Ministry of Health and the National Primary Health Care Development Agency has approved the administration of booster doses for persons that have completed two doses of AstraZeneca, Moderna, Pfizer Bio-N-Tech or 1 dose of Johnson & Johnson

“The Executive Director/CEO, National Primary Health Care Development Agency, Dr. Faisal Shuaib, has said the eligibility criteria for taking the booster dose are: Any person 18 years and above; time interval of 6 months or more after receiving the second dose of AstraZeneca, Moderna or Pfizer Bio-N-Tech; and time interval of two months or more after receiving the Johnson and Johnson vaccine.

“Consequent upon the above, eligible Nigerians are advised to visit the nearest health facility or mass vaccination site for their booster doses as from the 10th of December, 2021 across all states of the federation.

“According to Dr. Faisal Shuaib, a COVID-19 booster dose gives greater protection against the virus and urged all Nigerians to take advantage of the opportunity offered by the Federal Government of Nigeria. The list of the vaccination sites is available on the NPHCDA website: www.nphcda.gov.ng.”

Expect more variants, cases, NCDC tells Nigerians

The Nigerian Centre for Disease Control (NCDC) has urged Nigerians to brace up for more cases of the Omicron COVID-19 variant.

It noted that while mutations are common occurrences with viruses, the chance of the emergence of deadlier and transmissible variants increase with a rise in community transmissible

The NCDC therefore warned that as long as Nigerians continue to disregard preventive measures and protocols, they should equally expect more cases of the new variant, and more COVID-19 variants.

Recall that in the early hours of Wednesday, the NCDC announced that three cases of the Omicron COVID-19 variant had been confirmed as a result of sequencing some samples.

Also, the World Health Organization (WHO) had labelled the new variant a variant of concern (VOC) after it was seen to be more transmissible and an increased risk of re-infection.

The Director General of the NCDC, Dr Ifedayo Adetifa, who made this known on Arise Television during the week, also decried the low vaccination coverage across the country.

Read Also; COVID-19: Omicron variant now in 23 countries – WHO

He explained that alongside adherence to non-pharmaceutical interventions of regular hand washing and (or) sanitising with an alcohol based sanitisers, properly wearing face masks, and practicing physical distancing, vaccination remains the most potent strategy to prevent transmission, reduce transmission if infection should occur, and protect against severe disease and death.

He said: “It will not be surprising if we find more cases as we continue to sequence more of the samples that continue to accrue.

“This is reflective of the situation worldwide. As you know, by the minute, the number of countries that are reporting this variant continues to increase. We anticipate that this variant is everywhere and so we will give the same attention to all travelers coming into the country and all samples that are positive for COVID-19.

“The decision for a travel ban is not made by the NCDC. However, from a technical perspective we will not recommend a travel ban. We are subject to a travel ban ourselves by decisions that are not based on science.

“What we need is enhanced surveillance vigilance and we need our populations to adhere to recommended safety measures. At the last count, 22 plus countries have reported this variant. So when will the banning end if it starts?

“Variants will continue to emerge, and so far we have been lucky because we have not had the variant that has substantially changed the landscape of this disease for Africa and for Nigeria the way it has in terms of severity of disease and death as soon elsewhere. But that risk remains and the risk will persist if we do not do the things that we need to do to prevent transmission. One key thing is to just get vaccinated. Vaccines prevent transmission, reduce transmission if infection should occur, protect against severe disease and death.”

The WHO in a statement noted that African countries are stepping up measures to detect and control the spread of the Omicron variant as weekly new COVID-19 cases in the continent rise by 54 per cent due to an upsurge in southern Africa.

“In Africa, the Omicron variant has now been detected in four countries, with Ghana and Nigeria becoming the first West African countries and the latest on the continent to report the new variant. So far, Botswana and South Africa have reported 19 and 172 Omicron variant cases, respectively.

Globally, more than 20 countries have detected the variant to date. The two southern Africa countries account for 62 per cent of cases reported globally,” it said.

Speaking during a virtual briefing on COVID-19, the Regional Director of the WHO, Dr Moeti Matshidiso, urged countries to increase surveillance and genomic sequencing of samples to possibly detect the Omicron variant of COVID-19.

She said: “African countries are stepping up measures to detect and control the spread of the Omicron variant as weekly new COVID-19 cases in the continent rise by 54 per cent due to an upsurge in southern Africa.

“In Africa, the Omicron variant has now been detected in four countries, with Ghana and Nigeria becoming the first West African countries and the latest on the continent to report the new variant. So far, Botswana and South Africa have reported 19 and 172 Omicron variant cases, respectively.

“Globally, more than 20 countries have detected the variant to date. The two southern Africa countries account for 62 per cent of cases reported globally.

“Working with African governments to accelerate studies and bolster the response to the new variant, the World Health Organization (WHO) is urging countries to sequence between 75 and 150 samples weekly.

“The detection and timely reporting of the new variant by Botswana and South Africa has bought the world time. We have a window of opportunity but must act quickly and ramp up detection and prevention measures. Countries must adjust their COVID-19 response and stop a surge in cases from sweeping across Africa and possibly overwhelming already-stretched health facilities.

FG rules out lockdown, reviews travel protocol

The Director-General of the Nigeria Centre for Disease (NCDC), Dr. Ifedayo Adetifa yesterday said the government is not considering a lockdown over the detection of Omicron variant of Corona virus.

He also said the nation may not impose travel restrictions.

He however said the Presidential Steering Committee on COVID-19 has revised the nation’s international travel protocol.

He said the new protocol will become effective from December 5th.

He said the nation has enough COVID-19 vaccines but with a shortage of people to receive the doses.

Adetifa, who made the clarifications during an audience with select media in Abuja, said Omicron has been infecting young people between 19 and 35 years.

The Director-General spoke against the backdrop of three cases of the variant that have been detected in the country from some travellers from South Africa.

He said from evidence so far, there was no basis for a new lockdown.

He said: “Based on information, we have not reached a point where we will make a technical recommendation on lockdown.

“On travel ban, there is no sign that justifies the current ban. I am sure the Presidential Steering Committee on COVID-19and the Federal Ministry of Health will come up with a decision.

“We are not one of those people with knee-jerk reactions. We have not banned flights from anywhere.

“A lot is said about this new variant. In a lot of cases, many of the responses were being driven more by the fear of the unknown than exact science.”

He allayed fears on Omicron, Adetifa said: “Most of those infected with the variant are young people between 19 and 35byeats but not sick.

“We are still waiting for more information. If the virus becomes transmissible, it does not mean it is dangerous or more severe.”

Responding to a question, Adetifa said: “Nigeria has enough vaccines to vaccinate 40 to 50 per cent of the eligible population.

“There is no shortage of vaccines but shortage of people to receive the vaccines.”

The DG said the Presidential Steering Committee on COVID-19 has reviewed the International Travel Protocol of 22nd October 2021.

He made the revised protocol available to the media.

The latest protocol was signed by the Secretary to the Government of the Federation/Chairman, Presidential Steering Committee on COVID-19, Mr. Boss Mustapha.

It reads: “This revised protocol is aimed at further reducing the risk of importation and exportation of COVID-19 especially the variants of concern.

“All passengers arriving in Nigeria are expected to provide evidence of and comply with the following rules:

*COVID-19 PCR test to be done within 48hrs before departure

*Post-arrival Day 2 COVID-19 PCR test

*Self-isolation for 7 days (For unvaccinated and partially vaccinated individuals).

*Day 7 post-arrival exit PCR test (For unvaccinated and partially vaccinated individuals)

“All out-bound Passengers are required to provide either of the following documentation:

*Valid evidence of full vaccination against COVID-19

*Negative PCR test result within 48hrs from the time boarding

“The review of the protocol is based on science, national experience, and global developments.

“The PSC assures Nigerians, that it shall continue to monitor global and specific country situations with a view to taking necessary measures to safeguard the health of Nigerians.

“The PSC calls on all Nigerians to ensure that they have taken their full dose of COVID-19 vaccinations and to continue to observe compliance to public health social measures.”

Federal tertiary hospitals are prepared, says CMDs

The Committee of Chief Medical Directors (CMDs) and Medical Directors (MDs) of Federal Tertiary Hospitals, yesterday, stated that all Federal Medical Centres and Teaching Hospitals across the country are adequately prepared for any eventuality that may arise from  the new Omicron COVID-19 variant.

It stated that the Federal Government had already made adequate funding available for the equipping of health facilities should COVID-19 cases begin to increase.

The outgoing Chairman of the Committee of CMDs and MDs, Dr Jaf Momoh, while speaking during a briefing after its Annual General Meeting, alongside the new Chairman of the Committee, Prof Auwal Abubakar, noted that there is no lack of ventilators, oxygen, patient- space etc., at all federal tertiary hospitals.

He further urged the Federal Government to urgently release outstanding balances for outsourced services, while ensuring a clear policy on the emergency replacement of health workers without waiting for waivers.

He said: “The government has done a lot in providing funds to equip our hospitals. We have equipped brand new infectious disease centres that include an infectious disease intensive care unit, laboratory that can make molecular diagnosis in all the federal tertiary hospitals. Most of them are already up and running even with accreditation to do COVID-19 test.

The Lagos State Ministry of Education has shut down Dowen College Lekki Phase 1 indefinitely to allow for investigations into how one of its pupils, Sylvester Oromoni Jnr, died under allegedly controversial circumstances on Tuesday.

The closure follows a visit by the Education Commissioner Mrs Folasade Adefisayo and other top officials of the Lagos State Ministry of Education to the school on Friday.

The boy’s family claimed he died as a result of injuries he got from being beaten by fellow pupils forcing him to join a cult.

But the school claimed he got injured while playing football.

A statement by the Assistant Director, Public Affairs, Lagos State Ministry of Education, Mr. Ganiu Lawal, reads:

“The Lagos State Government has ordered the indefinite closure of Dowen College, Lekki , pending the outcome of an investigation into the death of Sylvester Oromoni Jnr, a student of the school.

Read Also: Controversy trails death of 12-year-old Dowen College student in Lagos

“Commissioner for Education Mrs. Folasade Adefisayo announced the closure after a meeting with the School Management and Staff.

“The Commissioner called for calm, saying no effort will be spared in getting to the root of the incident.

“The Commissioner, in an earlier statement, commiserated with Sylvester’s family.

“Lagos State Government sends its condolences to the Parents of 12-year-old Sylvester Oromoni Jnr.,a student of Dowen College, Lekki.

“The Commissioner for Education, Mrs. Folasade Adefisayo, notes that this incident is shocking and the State is indeed sad about this great loss.

“The State Government is in touch with the parents in this difficult time.

“We reassure the family of the late Sylvester Oromoni Junior and Lagosians at large that efforts are being made to unravel the circumstances leading to his demise, even as we reiterate the Government’s commitment to Child Protection.”

Besides serving as a barrier to testing and treatment, stigma is one major reason the AIDS epidemic still wreaks havoc around the world. HIV self-testing is one great weapon that can help in closing the huge testing gap and quicken the pace towards eradicating the virus, reports Associate Editor ADEKUNLE YUSUF

The endless grieving, sudden loss of friends and other loved ones– all hurriedly connived to make her world come down crashing around her. The pall of despair was so huge that it took her a long time to find her way again after the crushing crash. That was many years ago when the rumour mill in her school went agog that she was HIV-positive. It was a gigantic task she was obviously incapable of handling during her adolescent years, with schoolmates avoiding her like a plague. Helpless and desolate, Janet had erroneously assumed it was a death sentence.

But instead of joining hands to serve as bulwarks, friends and others whose support Janet badly needed to gather the broken pieces of her life chose to leave her in the lurch when she tested positive to HIV during her secondary school days in Lagos. Out of frustration, she quit schooling and had to forgo her dreams because “everybody was talking about me and pointing fingers at me.” After dropping out of school, she said she pictured herself committing suicide, terrified that testing positive for HIV would cut short her life because having the virus meant dying by instalments.

Now as an adult running a thriving hairdressing business, the secondary school dropout is now wiser, having finally come to terms with the reality of her status. But if Janet survived the stigma many years ago, even though the ordeal robbed her of her dream to be an accountant, many people are afraid to take the HIV test because of the stigma and discrimination many people living with HIV/AIDS (PLWHA) suffer in schools, offices, and neighbourhoods – including in health facilities.

According to Dr Gambo Aliyu, Director-General of the National Agency for the Control of AIDS (NACA), stigma and discrimination are the biggest obstacles impeding efforts to eradicate the epidemic. Reason: some people have the virus in them and are reluctant to come out and do the test, and some who come out and do the test and discover they have HIV; don’t want to come forward for treatment all because of stigma and discrimination.

The NACA boss said stigma is one recurring decimal that adversely affects every facet of HIV control and management activities, particularly the testing stage, which serves as the inevitable bridge that provides the linkage to diagnosis, care and treatment services around the globe. According to technical experts in HIV response programmes, stigma is the main reason that discourages people from getting tested to know their status; while undiagnosed HIV infection is directly responsible for continued transmission of the virus – a position that has been validated time and again through research.

As Civil Society for HIV/AIDS in Nigeria (CiSHAN) executive secretary, Walter Ugwocha, puts it, HIV-related stigma is what spreads the virus faster, since the fear of being stigmatised discourages people from accessing HIV testing and treatment. “If stigma prevents HIV-infected people from getting on to treatment, the virus will be allowed to flourish. People who don’t know they are infected with HIV would not know that they require treatment.”

Despite the tremendous progress made in the fight to tame the deadly virus, especially in the area of scaling up testing services, available facts have shown that many people who are not getting tested in high enough numbers that can offer assurance that the world is on the cusp of ridding itself of the deadly disease. As far as UNAIDS is concerned, nothing less than 25 per cent of PLHIV globally are yet to be tested or diagnosed. While there is a dire need to increase access to prevention, care and treatment, substantial gaps exist in testing coverage, especially among vulnerable groups and settings peopled by those who are disproportionately affected by HIV infections.

HIV self-testing as a tool for achieving UNAIDS’s 95-95-95 goals

According to WHO, HIV home-based tests, also known as self-tests (HIVST), allow people to test themselves for HIV in their homes without a healthcare provider present. In other words, HIVST refers to a process in which a person collects his or her own specimen (oral fluid or blood) and then performs an HIV test and interprets the result, often in a private setting, either alone or with someone he or she trusts. This is generally conducted using rapid test kits such as finger stick tests (on whole blood) or mouth swab tests (on oral-fluid).

Medical experts explained that non-reactive or negative self-test results are considered negative. But every reactive or positive self-test result always requires further testing and confirmation from a trained tester, with experts advocating that clear messages are essential to ensure users understand that HIVST does not provide a definitive HIV-positive diagnosis, and they (users) are aware of what to do after a reactive self-test result.

As Dr Aliyu explained it, benefits of self-testing include privacy, confidentiality, convenience, engagement in self-care, empowerment, and pro-activity in seeking health – all necessary to bridge the existing huge HIV testing gap without which early diagnosis or treatment is impossible.

In accordance with the July 2015 WHO Consolidated Guidelines on HIV Testing Services, individuals who test (including a self-test) in the window period (6 to12 weeks’ period before individuals develop HIV antibodies and HIV rapid tests can detect antibodies) or are at ongoing risk for HIV should be encouraged to re-test.

 Testing anyone, anywhere and anytime

In 2016, WHO published global HIV self-testing guidelines, recommending that HIV self-testing be offered as an additional approach to HIV testing. Many countries now have HIV self-testing policies in place; while those that are yet to do so are fast exploring modalities for having HIVST legalised and incorporated into their HIV response services.

But HIV self-testing has moved several notches higher, with the birth of OraQuick, an in-home oral swab test that detects HIV antibodies in saliva. The test requires users to swab their upper and lower gum lines for the saliva sample. The swab is placed in a solution, which allows the test reaction to develop. The test produces a result within 20 to 40 minutes. However, positive results received at home are considered preliminary and must be confirmed by clinic-based testing.

A few examples will suffice. In a study of students seeking care at the McGill University Health Centre, 98 per cent of students rated an oral self-test as convenient. In another study of at-risk individuals in Singapore, 95 per cent felt that the self-test kit instructions were easy to understand and the kit convenient to use. In another study in the United States, 96 per cent of participants reported that the OraQuick test was “not at all hard to collect.”

Efforts towards deepening access to HIVST

Not happy that both the state and federal governments have not embarked on aggressive public enlightenment campaigns to promote acceptance and use of approved HIVST kits, some civil society organisations have taken up the responsibility by promoting self-testing and training their members on how to use the kits. At a one-day training held in Abuja in July 2017, CiSHAN provided the platform for all its 36 state coordinators to use the OraQuick kits to demonstrate self-testing in the country.

In a communiqué issued after deliberations, CiSHAN welcomed the availability of HIV self-test kits in Nigeria, describing it as a welcome development that could facilitate access of persons who had concerned with facility-based HIV testing services. While urging all its constituent members to accept the national rollout of the HIV self-testing programme, CiSHAN said HIVST could help in closing the huge HIV testing gap and ensuring the country achieve the first 90 in the HIV response. It also called on all state governments to procure self-test kits and deploy same to institutions of learning and churches and facilitate its use during outreaches to community members as a way to bridge the gap in HIV testing coverage.

“It will also facilitate HIV testing as many times as any individual wants. The concern about pre-and post-test counselling for those who undertake HIV self-testing has been addressed through the current HIV testing algorithm defined in the country in the released but yet to be widely disseminated National Self-Testing Guidelines developed by the Federal Ministry of Health. Concerns about the cost of the kit, especially for rural communities and vulnerable groups including adolescents, young women and key populations who direly need it, were shared. The need to facilitate sensitisation of community members on the use of the self-test kits to prevent myths and misconceptions limiting its use and uptake was emphasised.

To get the HIVST message sink in, competitions are also being promoted to crowdsource ideas on how to improve HIV self-testing among young Nigerians. One of such competitions took place in June last year, where peer-to-peer distribution, youth-oriented branding, celebrity-endorsed social media campaigns emerged as top ideas in the crowdsourcing contest to improve HIVST among young people. The ‘4 Youth by Youth’ contest, which ran between October 2018 and June 2019, was touted as one of the largest health-based crowdsourcing contests, which challenged Nigerian youths between 10-24 years to come up with ideas to promote HIV self-testing within their age group.

Around 900 entries were received, around two-thirds of which came from people aged 15-24. Peer-to-peer distribution emerged as a key theme in some of the strongest entries. Entrants indicated that supportive discussions between young peer educators, operating as brand ambassadors could promote and increase awareness of HIVST, with schools, community centres, churches and other worship places identified as good avenues for self-testing promotion to take place, as these locations already serve large numbers of young people.

Suggestions on how to make HIVST kits more appealing included repackaging existing products with youth-friendly colours, taglines, designs and animations. Making the packaging smaller and more flexible for discretion was also proposed. The youths also emphasised the need for testing kits to be affordable, with suggested prices ranging from N500 to N1,000 and clear instructions provided in Hausa, Yoruba and Igbo, which are the three dominant languages in Nigeria, as a way to reach a wider range of young Nigerians. While some entries advocated using social media to reach young people, other entrants suggested asking local celebrities to endorse social media campaigns to generate demand among their young fans.

Promoters of the competition said using a crowdsourcing contest in the way outlined above resulted in young Nigerians becoming meaningfully engaged in the issue of self-testing, including a large number of young men. Because the majority of entrants took part via social media, the ideas put forward may be more likely to appeal to this sub-section of young people and might not be as relevant to young people who do not have internet access. This might include marginalised young people who are at higher risk of HIV, who could particularly stand to benefit from HIV self-testing.

“Engaging young people to identify solutions on how to promote HIV self-testing is important in developing HIVST campaigns…that will resonate with young people. Tapping into the rich wisdom of crowds may lay the groundwork for illuminating youth perspectives on HIVST that could potentially increase HIV testing among Nigerian youth,” they said.

 The state of HIV/AIDS journey – a global factsheet

Although concerted efforts by governments and international organisations have recorded great feats in the fight against the spread of the epidemic around the world, much still needs to be done. In Nigeria, HIV prevalence, defined as the percentage of PLHIV in the population of Nigeria, was 1.4% among adults aged 15-49 years and 1.9% among females and 0.9% among males. According to the NAIIS report, HIV prevalence among children aged 0-14 years was 0.2%. HIV prevalence was highest among females aged 35-39 years at 3.3% and the highest prevalence among males aged 50-54 years at 2.3%. The HIV prevalence gender disparity between females and males was greatest among younger adults, with females aged 20-24 years having 4 times the prevalence of males in the same age group. The new prevalence gives an estimate that there are 1.9 million people aged 0-64 years living with HIV in Nigeria.

According to the global HIV/AIDS statistics released recently by UNAIDS, 26 million people were accessing antiretroviral therapy as of the end of June 2020. About 44.5 million people globally were estimated to be living with HIV in 2019, while 2.2 million people became newly infected with the virus in the same year. In terms of fatalities, about 970 000 people died from AIDS-related illnesses in 2019, leaving about a total of 100 million people who have been infected with HIV so far since the start of the epidemic and 42.2 million people are estimated to have died from AIDS-related illnesses since the start of the epidemic.

As of 2019, there were about 44.5 million people living with HIV worldwide. A breakdown of the figure on people living with HIV showed that 42.5 million were adults, with 2.2 million children (0–14 years) estimated to be living with the virus. Sadly, only 81 per cent of all people living with HIV knew their HIV status; while about 7.1 million people did not know that they were living with HIV.

As of the end of June 2020, UNAIDS reported that 26 million people were accessing antiretroviral therapy. In 2019, 25.4 million people were accessing antiretroviral therapy, up from 6.4 million in 2009. In 2019, 67 per cent of all people living with HIV were accessing treatment; while 68 per cent of adults aged 15 years and older living with HIV had access to treatment, as did 53 per cent of children aged 0–14 years. Reports had it that 73 per cent of female adults aged 15 years and older had access to treatment; however, just 61 per cent of male adults aged 15 years and older had access.

On a brighter note, 85 per cent of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their children in 2019. Another commendable feat is that new HIV infections have been reduced globally by 40 per cent since the peak in 1998. In 2019, around 1.7 million people were newly infected with HIV, compared to 2.8 million people in 1998. Since 2010, new HIV infections have declined by 23 per cent from 2.1 million to 1.7 million in 2019. For children, since 2010, new HIV infections among children have declined by 52 per cent from 310,000 in 2010 to 150,000 in 2019.

Also, AIDS-related deaths have been reduced by 60 per cent since the peak in 2004. In 2019, around 690,000 people died from AIDS-related illnesses worldwide, compared to 1.7 million people in 2004 and 1.1 million people in 2010. For women, it is, however, not yet time for a victory dance. Every week, around 5,500 young women aged 15–24 years become infected with HIV. In sub-Saharan Africa, five in six new infections among adolescents aged 15–19 years are among girls, with young women aged 15–24 years being twice more likely to be living with HIV than men. Women and girls accounted for about 48 per cent of all new HIV infections in 2019.

 Still a long walk to achieving the 95-95-95 targets

While there has been immense progress towards UNAIDS’ 95-95-95 targets for prevention and treatment of HIV, it’s an open secret that the world has failed to achieve the ambitious three targets by the 2020 deadline, which it set for itself in 2014 (90-90-90). The first 90, 81 per cent of people living with HIV knew their HIV status in 2019. Among people who knew their status (second 90), 82 per cent were accessing treatment. And for the third 90, among people accessing treatment, 88 per cent were virally suppressed.

What all the figures by global health bodies showed is that all regions fell behind in the 90-9-90 targets – though the magnitude of the crisis is skewed against developing countries with poor health care systems. And as the raging COVID-19 pandemic continues to wreak havoc in more than two hundred countries and territories, HIV technical experts said the failure to meet the 2020 targets in the fight to control HIV/AIDS is likely to be worsened by unpredictable financing for HIV activities, which is a direct consequence of disruptions in the global economy.

Unfortunately, the failure is more pronounced in resource-poor countries like Nigeria, which depend largely on donor funds to prosecute the war against HIV/AIDS. This means there is still a huge task ahead for Nigeria – a task that experts believe cannot be accomplished until barriers to accessing HIV testing services in the country are addressed more vigorously through a combination of innovative testing techniques, including HIVST. Therefore, if Nigeria is to join the global race towards ending AIDS by 2030, experts say there must be a massive expansion in HIV testing and treatment resources everywhere in the country!