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#PEPFARat20: Strengthening Nigeria’s Military Healthcare System through WRP-N

On January 28, 2023, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) marked its 20th anniversary.  PEPFAR is the largest commitment by any nation to address a single disease in history and represents the best of American values.  Over the past 20 years, the United States has invested over $100 billion in the global fight against HIV/AIDS and supports more than 20.1 million people on HIV treatment in over 50 countries globally.


In Nigeria, PEPFAR has disbursed over $7.8 billion to ensure that all Nigerians living with HIV/AIDS have comprehensive access to quality HIV prevention, care, and treatment services. This investment translates to providing over 1.9 million Nigerians with access to antiretroviral treatment (ART). Today, Nigeria is on the cusp of HIV epidemic control and is approaching the global “95-95-95” goals defined as: 95% of people with HIV know their HIV status, 95% of those with diagnosed HIV infection are accessing treatment, and 95% of those receiving treatment have achieved an undetectable viral load.


Since 2005, the Walter Reed Program-Nigeria (WRP-N) has been a proud PEPFAR implementer. Through PEPFAR’s support, the program has grown from an initial four military health facilities in 2005 that focused on HIV prevention and currently supports 34 military health facilities – providing quality comprehensive HIV services for Nigerian troops, their families, and civilians in their communities. These services include HIV testing and counseling; adult and pediatric HIV and TB/HIV care, treatment and support; and prevention of mother-to-child transmission of HIV.


Nigeria’s military laboratory systems have been strengthened, thanks to the funding provided by PEPFAR. The Defence Reference Laboratory (DRL), an internationally accredited laboratory by the American Association for Laboratory Accreditation, with state-of-the-art equipment was equipped by PEPFAR. DRL supports the surveillance of infectious pathogens as well as HIV viral load diagnosis and monitoring. PEPFAR also supported four military laboratories in Nigeria to attain 5-star accreditation status by both the African Society for Laboratory Medicine (ASLM) and the Medical Laboratory Science Council of Nigeria (MLSCN).


In addition to laboratory support, PEPFAR has also invested in improving infrastructure at 34 military facilities in Nigeria. Noteworthy is the renovation of the pharmaceutical-grade warehouse at the Nigerian Army Central Medical Store Yaba, Lagos, which supports the warehousing of HIV and related commodities. PEPFAR also provided laboratory infrastructure, medical equipment and supplies, capacity building across the clinical cascade, and improvement of the health information management system through the provision of electronic medical records (EMRs) and implementation of DHIS for data reporting.


Furthermore, PEPFAR supported the development of the Armed Forces HIV/AIDS Control Policy in 2021 to provide a conducive policy environment for HIV/AIDS and expanded the policy to include research on emerging and re-emerging infectious diseases. A 5-year strategic plan was also developed in 2021 to provide direction for the military-to-military program.


PEPFAR’s investments in military health care in Nigeria have yielded significant results in addressing the HIV epidemic and improving the overall health of the country’s military personnel and their families.