Abstract
The Challenge
The United States Agency for International Development (USAID), through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), strengthens Nigeria’s HIV response by increasing access to comprehensive HIV services through the private sector. The UNAIDS AIDSinfo database estimates that Nigeria has the second largest population of people living with HIV (PLHIV) in the world at 3.2 million; in 2017, only 967,000 were on antiretroviral therapy (ART). To reach global 90-90-90 goals, an additional 1.6 million PLHIV will need to start ART by 2020. Nigeria must leverage its full range of human, financial, and technical resources to rapidly accelerate progress to achieve this goal. In Lagos and Rivers states, where over 350,000 PLHIV are not on ART (figure below), the private sector is a largely untapped partner that can make significant contributions.
The Opportunity
Nigeria’s private sector is an important partner in the health system, as it currently delivers approximately half of non-HIV health services in the country. However, private provision of HIV services is low, especially for care and treatment. While approximately two-thirds of private providers in Lagos offer HIV counseling and testing services, only 10 percent offer full adult ART.* Increasing the number of private providers who deliver the full range of HIV services or improving the reach of and access to private providers who already offer HIV services can help create stronger linkages to care for PLHIV tested at private facilities. Economic growth over the past two decades has increased incomes that could support an expanded private delivery of HIV services, if channeled through appropriate financing mechanisms.
