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High numbers of people dying from AIDS in sub-Saharan Africa, MSF reveals.

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AN unacceptably high number of people continue to develop and die of AIDS[1]-related diseases across sub-Saharan Africa. They remain left out of the global HIV response without access to treatment that prevents AIDS or the medical care they need, says international medical humanitarian organisation Médecins Sans Frontières / Doctors Without Borders (MSF).

In MSF’s briefing paper “Waiting isn’t Option: Preventing and Surviving Advanced HIV[2]” , data from MSF-supported hospitals presented at the International AIDS Society (IAS) Conference on HIV Science in Paris today, highlights that in MSF-run and MSF-supported hospitals in Democratic Republic of Congo (DRC), Guinea, Kenya and Malawi, people arrive with such severe immune failure that overall mortality for patients presenting with AIDS is between 30-40%. Almost one-third of those deaths occur within 48 hours.

The main causes of illness and death are due to treatment failure or interruption and late diagnosis leading to delayed treatment. Unlike in the early 2000s, when little treatment was available, more than 50% of AIDS admissions at referral hospitals supported by MSF had already started antiretroviral therapy (ART), with many showing clinical signs of treatment failure. “Despite extensive access to antiretrovirals, there has not been the expected drop in late-stage presentations of HIV in developing countries. What’s different is that among people admitted to hospitals, the majority are already diagnosed and many have been on treatment for several years. In Kenya, in Homa-Bay, where antiretrovirals have been available for years, half of the patients hospitalised AIDS cases show signs of treatment failure. We’re pushing to switch these patients to second-line antiretrovirals more rapidly,” says David Maman, MSF Epicentre epidemiologist.

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At community level, MSF population surveys also show that a proportion of people living with AIDS in communities in southern and eastern Africa remain untested and untreated. Around 10% of people living with HIV in districts of Malawi, Kenya and South Africa had AIDS, of which 47% had never received testing or treatment. “People are still being diagnosed late. We need new ways to detect those left out, early on, before they arrive at hospital in often fatal condition or die at home without ever receiving care. Stigma and lack of information still remain high, leading to delayed treatment or no testing and treatment at all. This illustrates the need to complement increased antiretroviral coverage at community level with improved care for those on treatment for years,” says Gilles van Cutsem, MSF HIV Advisor.

Clinicians, including from MSF, have increasingly voiced concern over the lack of attention and means going towards the prevention and treatment of AIDS across Africa. The World Health Organisation (WHO) yesterday issued its first ever guidelines for the treatment of AIDS in low-resource settings. While this is a positive step forward, MSF calls for the urgent implementation of the guidelines with additional measures to address potential drug resistance and treatment failure.

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Key interventions urgently needed to prevent and treat AIDS include the rapid rollout of ‘test and start’, CD4 baseline testing at ART initiation, routine viral load testing, point of care diagnostics for tuberculosis, improved treatment for cryptococcal meningitis, rapid switch to second-line ART for failing and advanced patients, and swift, effective and accessible treatment for opportunistic infections. MSF is also calling for models of care geared towards prevention, treatment and support for patients with AIDS, and free specialised hospital-based care free of charge for patients[3].

MSF is also concerned that the situation will only be exacerbated as funding for the global HIV response continues to stagnate. Anticipated cuts in US funding to the Global Fund (17%) and PEPFAR (11%) from 2018 onwards will see many countries facing further grant restrictions. Shrinking funding envelopes and the need to preserve ART purchases will imperil community responses, including targeted testing and improved treatment literacy and adherence, while starving essential investments needed for health workers, laboratory and diagnostics.

“Each patient presenting with AIDS is a terrible testimony to the challenges to get timely access to test & treatment and to continue their ART uninterrupted. With global political will and funding for HIV on the decline, not only is the broader fight against the virus at risk go into reverse but specifically these patients arriving at hospitals sick with AIDS will have any hope of reprieve snatched away,” says Mit Philips, MSF Health Policy Advisor.

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[1] Acquired Immune Deficiency Syndrome (AIDS) is defined as a CD4 count of less than 200 or WHO clinical stage 3 or 4.

[2] Advanced HIV is synonymous with Acquired Immune Deficiency Syndrome (AIDS).

[3] MSF’s report ‘Les Négligés de L’infection au VIH’  also released at IAS, shows the lack of referral-based hospital care for treating AIDS in Kinshasa

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Kidnappers Must Be Treated As Terrorists – Tinubu Declares

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In a stern address at a Ramadan dinner with members of the Federal judiciary, President Bola Tinubu declared that individuals involved in despicable crimes such as kidnapping must be treated as terrorists.

The President, speaking passionately, reiterated the government’s unwavering commitment to defeating banditry, labeling those who engage in kidnapping as cowards incapable of confronting the might of the Nigerian Armed Forces.

“We must treat kidnappers as terrorists,” President Tinubu asserted, as reported by his spokesman, Ajuri Ngelale. “They are cowardly. They have been degraded. They look for soft targets. They go to schools and kidnap children and cause disaffection. We must treat them equally as terrorists in order to get rid of them, and I promise you we will get rid of them.”

The President made these remarks during the dinner attended by serving and retired judicial officers, including notable figures such as former Chief Justices of Nigeria, Justice Mahmud Mohammed, and Justice Walter Onnoghen.

The event provided a platform for discussions on various issues, including the escalating security challenges faced by Nigeria, particularly in the North-West and North-East geopolitical zones.

Nigeria has grappled with terrorism, banditry, kidnapping, and oil theft, with the aforementioned regions experiencing a surge in insurgent and bandit attacks over the last decade.

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President Tinubu’s government has remained steadfast in its stance of not negotiating with bandits, despite the continued abduction of schoolchildren and residents for ransom.

The recent mass abduction of 137 schoolchildren from Kuriga in Kaduna State serves as a stark reminder of the ongoing security threats.

The President also addressed the need for judicial reforms and improved welfare for judicial officers.

Recognising the challenges faced by the judiciary, President Tinubu pledged to implement necessary reforms to enhance the welfare and working conditions of judicial officers. He emphasised the importance of fair compensation and support for the judiciary, acknowledging their pivotal role in upholding the respectability of the judicial arm of government.

In response, Chief Justice of Nigeria, Justice Olukayode Ariwoola, commended President Tinubu for his commitment to judicial reforms and for hosting the Ramadan dinner in honour of judicial officers.

The Attorney-General of the Federation and Minister of Justice, Lateef Fagbemi, also expressed gratitude to the President for forwarding the executive bill aimed at addressing the stagnant state of judges’ salaries and allowances since 2007.

President Tinubu’s declaration underscores the government’s resolve to combat insecurity and hold perpetrators of heinous crimes accountable.

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Abiodun Unveils 50% Discount Rice Scheme to Aid Ogun Residents

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Governor Dapo Abiodun of Ogun State has said that his administration will commence the sale of rice at half the market price across the state to alleviate the prevailing economic challenges in the country..

Addressing attendees at a special Iftar organised for the League of Imams and Alfas in Abeokuta, Governor Abiodun emphasised the importance of alleviating the economic burden on the public, particularly civil servants.

He stated, “We have decided to commence the sale of rice. We will be selling it at the rate of 50% of the actual price.”

Highlighting the significance of restoring the purchasing power of public servants, the governor affirmed that the initiative aims to counter the impact of inflation.

He asserted, “What we are trying to do is put them in the position they were before the inflation.”

The governor disclosed the establishment of a committee to oversee the distribution of rice to residents, ensuring transparency and accessibility.

He emphasised the sustainability of the programme, stating, “If we sell at the price it was sold before it becomes expensive, it will allow us to use the money to buy more and continue to sell.”

Also, the governor pledged free rice distribution to the less privileged segments of society, including the poor, elderly, and vulnerable individuals.

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Encouraging Muslims to uphold virtuous behavior beyond the fasting period, Governor Abiodun urged continuous prayers for the well-being of the state and the nation.

He reiterated his commitment to constructing a modern secretariat for the League of Imams and Alfas, promising a landmark facility that would set a standard for other states.

In recognition of his efforts towards peace and empowerment, Governor Abiodun was honoured with the title of Ambassador of Peace in Islam during the event.

Attendees also offered special prayers for the upcoming 72nd birthday celebration of President Bola Tinubu, scheduled for March 29th.

Imam Tajudeen Adewunmi, the Secretary of the League of Imams and Alfas, commended Governor Abiodun for his dedication to empowering Muslim youths and fostering goodwill within the community.

 

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Makinde’s Ibadan Circular Road Project, A Monumental Fraud – Says Oyo APC

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The All Progressives Congress (APC) in Oyo state has cried out over alleged monumental fraud which the party claimed it discovered in the partial execution of the Ibadan Circular Road Project, warning the administration of Governor Seyi Makinde that the unabated corruption being perpetrated by the ruling People’s Democratic Party (PDP) could plunge the state into irredeemable doom in the nearest future.

At the commissioning ceremony which took place at Badeku Junction on Ife-Ibadan Express Road last Friday, Governor Makinde announced that the Ibadan Circular Road Project which, according to him, was the largest investment in Oyo state in 50 years had cost a whooping sum of N300billion.

Anambra state governor, Prof. Charles Soludo, was the Special Guest of Honour at the event.

In a reaction which was contained in a statement issued today and made available to journalists in Ibadan by its Publicity Secretary, Olawale Sadare, Oyo APC queried the governor on the rationale behind the government’s redesign of the road project to occupy 425 meters as setbacks in both sides when the standard measure for any Trunk ‘A’ road does not exceed 60 meters across the globe.

“So, the ongoing indiscriminate demolition of properties of poor citizens is to serve the interest of the governor and his cronies”.

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“Many questions are begging for answers as far as this matter is concerned; how did Governor Makinde spend N300billion on less than a quarter of the whole project when his predecessor, late Senator Abiola Ajimobi, had awarded the contract for its design, construction, and completion as well as payment of compensation to those who might lose their properties to construction activities at a total cost of N70billion in June 2017 while the contractor had done about 20 percent of the work before he was sent away when the PDP government came on board in 2019?

“In July 2021, Governor Makinde announced that he had re-awarded the same project to another contractor at a total sum of N138.2billion but last Friday when a stretch representing about a quarter of the whole project was being commissioned (for suspended use by the public), the governor claimed the completed portion had gulped N300billion. The entire circular road project was designed to cover 110 kilometers and the whole world wants to know the fraction which has now cost N300billion to be done and also, how much the remaining three quarters would cost.

“Meanwhile, tongues would continue to wag on the issue of the large expanse of land forcefully acquired from the owners in the name of road construction. The fact remains that the people of the state cannot trust a government that is popular for land fraud as is the case in Ajia, Wofun, Bashorun, Bodija, and Land Lagos Express Road among others in the last four years. Those hapless landowners are accusing Governor Makinde of a surreptitious plan to seize their land and later sell it to some strangers from the East.

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“Another issue of concern is that of the supposed Agodi-Gate Junction Improvement project which has been identified as another conduit to siphon the resources of the state. All the state is doing is evacuating roadside traders, clearing some blocked drainages, laying light asphalt, and installing traffic lights, then later claiming several billions of naira as the cost of the exaggerated repair works on the popular junctions at Ibadan Civic Centre and Agodi-Gate.

“The sad thing is that the proceeds of these inflated contacts end up in private pockets without any trace. This kind of funds is what some governors in other states are using to rejig agriculture, fix the education sector, and address hardship among the masses among other things in their domains. Public primary and secondary schools are in dire need of subject teachers, virtually all the inner and access roads are in bad shape, no public tap water anywhere in the state, the population of the poor increases every day, and yet, Gov. Makinde mis-appropriates scarce resources to the detriment of the welfare of the people. This has to stop.” APC said.

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