Ofure Akhigbe
As Nigeria marks World AIDS Day 2025 with the theme “Overcoming Disruption, Transforming the AIDS Response,” medical experts have said the country can achieve HIV epidemic control if people living with the virus consistently adhere to antiretroviral therapy (ART).
Given the effectiveness of ART, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and other stakeholders in the fight against HIV have assured that it is possible to end the AIDS epidemic by 2030 through sustained and effective use of treatment.
World AIDS Day, marked annually on December 1, serves as a global reminder of the fight against HIV/AIDS, the progress made so far, and the gaps that still exist.
Experts noted that the days of HIV as a dreaded disease are numbered, affirming that with effective use of ART, Nigeria and the rest of the world can reach a point where no new infections occur — a stage referred to as epidemic control.
Although there is currently no cure for HIV, physicians stressed that with proper medical care, the virus can be controlled. They said people living with HIV who access effective treatment can live long, healthy lives and also protect their partners from infection.
According to the World Health Organisation (WHO), with access to effective HIV prevention, diagnosis, treatment and care — including management of opportunistic infections — HIV has become a manageable chronic health condition that allows people to live productive lives.
The WHO explained that HIV treatment requires a combination of antiretroviral drugs to suppress viral load, strengthen the immune system and reduce the risk of opportunistic infections and HIV-related cancers. The main goal of treatment, it said, is to reduce illness and death, improve quality of life and prevent transmission.
The global health body also noted that people living with HIV are more likely to develop tuberculosis, adding that TB remains one of the leading causes of death among HIV-positive persons worldwide.
A Professor of Haematology and Blood Transfusion at the College of Medicine, University of Lagos, Prof. Sulaimon Akanmu, said the advent of antiretroviral therapy has provided a strong pillar of hope in tackling the virus.
He said, “What the virus has done to humanity, God Almighty has given humanity the knowledge to be able to tackle the virus.
“With effective use of antiretroviral therapy, we can reach a point where no new infections will occur because everyone living with HIV who is on effective ART will be incapable of infecting another person. That marks the beginning of epidemic control.”
Akanmu explained that effective ART can add at least 33 years to the life expectancy of people living with HIV, noting that when viral load becomes undetectable, the likelihood of transmission becomes extremely low.
“It is calculated that a person living with HIV on effective treatment will infect less than one person in 33 years. These are the metrics being achieved in many countries and will soon be achieved in Nigeria.
“That is why we say the Incidence–Prevalence Ratio of 1:33 must be achieved. The day we attain that is the day we can confidently say epidemic control has been achieved. But that also implies no new infection is occurring,” he added.
The Sustainable Development Goal 3.3 targets an end to the AIDS epidemic by 2030, primarily through a drastic reduction in new infections.
HIV epidemic control, according to the WHO, refers to the reduction of disease incidence, prevalence, morbidity and mortality to a locally acceptable level as a result of deliberate public health efforts.
The former President of the Nigerian Society for Haematology and Blood Transfusion also stressed the need to differentiate between new infections and previously existing cases among those who test positive.
He said, “We can only achieve that if the country adopts fourth-generation HIV screening kits which can distinguish recent infections from long-standing ones. I strongly recommend this to the Federal Ministry of Health and the National Agency for the Control of AIDS.”
According to the National Agency for the Control of AIDS (NACA), an estimated 1.8 million people are currently living with HIV in Nigeria, out of which about 1.63 million are already on life-saving ART.
A retired Chief Research Fellow at the Nigerian Institute of Medical Research, Yaba, Lagos, Dr. Dan Onwujekwe, emphasised the importance of placing HIV-positive pregnant women on treatment to prevent mother-to-child transmission.
He explained that HIV can be transmitted from an infected mother to her child during pregnancy, delivery and breastfeeding if treatment is not commenced early.
Onwujekwe said, “It is compulsory to test all pregnant women for HIV during antenatal care. This helps in preventing mother-to-child transmission.
“If we can provide antenatal care to every pregnant woman and offer routine HIV testing, we will be able to detect those who are positive and place them on treatment.
“When treatment starts three to six months before delivery, the chance of transmitting the virus to the baby is extremely low. Unfortunately, many babies in Nigeria are still being born with HIV because their mothers were not tested during pregnancy.”