In 2002, Nigeria had 2.7 million people living with HIV/AIDS, the fourth-largest total of any country. The epidemic had already killed a total of 1.7 million people and orphaned 1.5 million children. The country’s nascent efforts to fight the disease were limited to a few severely under-funded health sector initiatives.
The Nigeria HIV/AIDS Program Development Project was launched in 2002 to lay the foundation for better HIV/AIDS prevention, care, and treatment services at the federal, state, and local levels. The project aligned well with the federal Government's HIV/AIDS Emergency Action Program. It aimed to support federal and state-level coordination mechanisms; expand the public sector response; and encourage a more active civil society response through an HIV/AIDS Action Fund. In addition, the project strongly supported a coordinated donor response.
The project has contributed to expand access to support networks and HIV/AIDS care. It has also been credited for increased knowledge on HIV prevention through community-based advocacy, particularly in remote areas.
- Health centers created. A total of 640 counseling and testing centers were established and are in operation, compared to the project target of 774 (one per local government area).
- Businesses got involved. The private sector response has been encouraging, with the formation of the Nigeria Business Coalition against AIDS. Currently, most multinationals now have HIV/AIDS programs for employees and host communities, and 127 private enterprises offer some sort of HIV/AIDS prevention program to their workforce.
- Institutional capacity enhanced. The National Action Committee on AIDS and State Action Committees on AIDS were established in all 36 states with the official mandate to coordinate the multi-sectoral response. The national committee was legally transformed into an agency in 2007, bringing institutional stability and a formal budget from the federal Government. Similarly, 14 state committees have acquired agency status.
- The Government practiced what it preached. At the federal level, 28 government ministries and agencies have developed and implemented HIV/AIDS action plans targeting both the staff (through HIV Workplace Policies) and the clients of implementing agencies.
- Civil Society has become increasingly active. More than 1,500 civil society organizations have implemented prevention, care and treatment programs through project funding.
The First Nigeria HIV/AIDS Program Development Project launched in 2002, with a total IDA contribution of US$90.3 million. An additional IDA financing of US$50 million was approved in 2007.
Multiple international donors are working on HIV/AIDS in Nigeria including among others: the Department for International Development (DfID), The US President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund for AIDS, TB and Malaria, the CIDA and components of the UN system. Strengthened donor coordination around the Government's HIV/AIDS Emergency Action Program and subsequent National Strategic Framework is an important result of the project. The flexibility of IDA financing allowed the project to adjust to substantial changes in donor programs over time and fill funding gaps, particularly those related to work on prevention.
Lessons learned from a joint review of the first project laid the foundation for the Second HIV/AIDS Program Development Project, which launched in 2009. Of the total project budget of US$230 million, IDA is financing US$225 million. It aims to extend the interim positive results associated with the first project and is set to run through 2013.