Last year alone, the US contributed $ 3.7 billion to humanitarian aid to sub -Saharan Africa. At least 73 percent of these have been assigned to health programs, including HIV treatment and prevention. For those living with HIV, much of the benefit of this funding has come through the president’s emergency plan for AIDS relief -or Pepfar, which buys and delivers HIV medication for countries in need. Since being launched by former US President George W. Bush more than two decades ago, Pepfar has saved millions of lives in Africa.

Before Pepfar, HIV often means a death sentence in Africa. Many people living with the virus can lead a normal life these days thanks to medicines that have been published. Aid programs have also enabled countries south of the Sahara to make important progress in containing the HIV epidemic via the recording rate of infection, improving testing and reducing mother-to-child transfer.

In reality, many countries in Africa, including Nigeria, are about to control the HIV epidemic and approach the global goals “95-95-95”-where 95 percent of people living with HIV are diagnosed, 95 percent Of the diagnosed, antiretroviral therapy receives, and 95 percent of those receiving antiretroviral therapy, effect viral suppression, and there is where a patient has no observable HIV and is effectively free from the risk of transferring the virus.

Now, with the lifeline of Pepfar that seems to be about to go, public health workers are concerned that these profits can be reversed. “We will have an almost collapse of the healthcare system if all financing is stopped after freezing 90 days, because the government of Nigeria alone cannot provide the necessary services,” says Isah.

Isah and his colleagues published a study in 2021 on the willingness of people living with HIV in Nigeria to pay for treatment outside the pocket. This research has found that while many people recognize the life -saving importance of their treatment, and therefore willing to pay, the cost of medication is a major obstacle to them.

A month’s value of the generic version of Truvada, a drug used to treat HIV, as well as to protect before and after exposure from infection, costs about $ 60 a month. In addition, there are the cost of regular laboratory tests to check virus load, health of the immune system, and for kidney conditions and conditions of the liver and heart that can be caused by infection. For low -income countries in Africa, this presents a major challenge: at least 41 percent of the population of sub -Saharan Africa lives on less than $ 1.90 per day; The national minimum wage in Nigeria is $ 40 per month.

Earlier this week, the government of Nigeria voted the readiness to join the financing gap for 4.8 billion Naira ($ 3.2 million) released to acquire 150,000 HIV treatment sets. But while it is a good sign for the short term, it is nowhere near that is necessary to keep the country’s HIV treatment and prevention program going in the event of a long-term withdrawal of Washington support.

If the US funding freezes after the 90 -day break, many people living with HIV in Africa will probably not be able to pay consistently out of the pocket for the medication and laboratory testing they need. “Once someone has fully medication and the person has reached undetectable virus load, it means that the person cannot transmit the virus,” says Isah. “But if they miss their treatment and medication, the viral burden can increase again, leading to the threat of their families and loved ones.”