09/09/2026
Why the HIV Response Must STEP UP in Nigeria TODAY
"Step" means intensify, accelerate, and sustain. 2026 is a critical window for Nigeria because of new infections, shrinking donor funds, and the emerging leadership across Nigeria.
The Burden Is Still Too High
Nigeria still carries the 4th largest HIV epidemic in the world with about 1.9 million people living with HIV. Every year we still see roughly 75,000 new infections and about 42,000 AIDS-related deaths. Most of these deaths are preventable if people are tested early and kept on treatment. If we slow down now, we will only keep adding to these numbers.
We Have Not Yet Closed the 95-95-95 Gaps
The UNAIDS goal is for 95% of people to know their status, 95% of those to be on treatment, and 95% of those to be virally suppressed. We are close, but not there. Many men and adolescents still don’t know their status. Some people on ART drop off because of stigma, drug stockouts, or transport cost. And when someone is not virally suppressed, the risk of transmission continues. We need to find these gaps and close them fast.
Young People, Key Populations and Children Are Being Left Behind
Adolescent girls and young women 15-24 still account for a disproportionate share of new infections because of GBV, poverty, and intergenerational s*x. Key populations like MSM, s*x workers and people who inject drugs have HIV rates 10-20 times higher than the general population, yet they face the worst stigma and have the poorest access to services. Babies are also still being born with HIV because PMTCT gaps have not been fully closed. Leaving any group behind means the epidemic continues.
Economic Challenges Are Driving the Epidemic
Poverty and unemployment make people more vulnerable. Transport fare to clinic, loss of income on clinic days, and lack of food for people on ART all lead to treatment interruption. For young people, economic pressure pushes some into risky survival s*x and transactional relationships. If the HIV response does not address livelihoods, skills, and social protection, we will keep seeing new infections linked to economic hardship. Investing in economic empowerment is investing in HIV prevention.
Substance Use and Drugs Are Increasing Risk
Alcohol and drug use lowers decision-making and increases risky s*x and needle sharing. People who inject drugs face dual risk of HIV and hepatitis. Yet stigma makes it hard for them to access testing, PrEP, and harm reduction services. We must integrate harm reduction, mental health, and psychosocial support into HIV programs so that no one is pushed further underground.
Funding and Sustainability Are At Risk
Donor funding from PEPFAR and Global Fund is transitioning, and domestic funding from state and LGA budgets is still less than 10% of what we need. If Nigeria does not take more ownership now, we risk treatment interruptions, commodity stockouts, and a reversal of the gains we have made over the last 15 years. This is the time to put HIV on LGA budgets and protect it.
A New Opportunity With new Dispensation
The good news is that a new dispensation has just started. This is the perfect time to integrate HIV services into PHCs alongside TB, FP, and NCDs. LGAs can use their budgets for commodities, health workers, and community outreaches. Community-led monitoring can also help stop stockouts and stigma at facility level before they become big problems.
The Tools to End AIDS Are Ready
We have what we didn’t have 10 years ago. U=U means Undetectable equals Untransmittable treatment is prevention. PrEP and PEP can stop new infections. HIV self-testing and multi-month dispensing make it easier for people to know their status and stay on drugs. If we don’t scale these now, we are wasting science.
A Strong HIV Response Strengthens the Whole Health System
HIV does not exist in isolation. It overlaps with TB, hepatitis, malaria, and maternal health. When we strengthen HIV labs, supply chains, data systems, and community health workers, all other health programs benefit too. A resilient HIV response builds a resilient health system.
If we step up the HIV response in Nigeria today, we can end AIDS as a public health threat by 2030. We will save lives and save money because treatment is cheaper than treating AIDS complications. We will protect the next generation so no child is born with HIV. And we will build stronger, more accountable health systems at LGA level.
The risk of slowing down is a rebound. The opportunity to step up is to finish the job.
World Economic Forum World Health Organization (WHO) United Nations UNODC - United Nations Office on Drugs and Crime Hamza Aliyu Oniovokukor Bright Indomitable Youths Organization International IDEA Civil Society for HiV/Aids in Nigeria - Cishan MacArthur Foundation
