Nigeria plans to use the bulk of the $121 million in interim applicant funding for three HIV grants (first announced in this GFO article) to pay for drugs and other health products. The Global Fund Board approved the funding request from the country coordinating mechanism, but with some modifications.
With three million people currently living with HIV, Nigeria has an HIV prevalence of 4.1%, constituting 9% of the global HIV burden. In addition, Nigeria has one of the highest TB burdens in the world and the largest TB burden in Africa (311 per 100,000 population). Nigeria's HIV epidemic is generalised; however, prevalence varies widely among states and between rural and urban areas. Nigeria's epidemic is largely fuelled by heterosexual and mother-to-child transmission, but key affected populations (KAPs), who constitute about 1% of the adult population, play a crucial role in driving the epidemic and account for 40% of annual new infections.
When the transition phase of the new funding model (NFM) was launched, $121 million was identified for Nigeria as an interim applicant (for HIV). The Nigeria country coordinating mechanism (CCM) submitted a proposal for $119.6 million. The CCM requested that the funds be added to three existing single-stream-of-funding (SSF) grants - NGA-H-NACA, for which the principal recipient (PR) is the National Agency for the Control of AIDS (NACA); NGA-H-ARFH, for which the PR is the Association for Reproductive and Family Health; and NGA-H-SFHNG, for which the PR is the Society for Family Health.
The CCM's proposal focused on the need to address critical commodity gaps; 97% of the proposed budget was earmarked for drugs and other health products. In addition to scaling up the provision of antiretroviral treatment and the prevention of mother-to-child transmission of HIV (PMTCT), the proposal included activities to (a) enhance the diagnosis of TB among people living with HIV; (b) enhance the coordination of TB and HIV programmes; (c) provide additional funding for the Integrated Biological and Behavioural Surveillance (IBBS) survey for KAPs; and (d) reduce barriers to accessing services, and support community mobilisation to improve service utilisation and adherence to treatment in 16 states not already targeted under the current SSF grants. The current grants are implementing activities to reduce barriers etc. in 21 states. The funding request also called for increasing the efforts underway in the 21 states.
