Nigeria Moves to Locally Produce HIV Drugs as U.S. Aid Suspension Raises Alarm

The Nigerian government has announced plans to commence domestic production of HIV test kits and antiretroviral drugs before the end of 2025, a move that comes amid growing concerns over the sustainability of HIV treatment programs following the suspension of U.S. foreign aid by President Donald Trump.

The decision, which affected funding through the United States Agency for International Development (USAID), has exposed millions of beneficiaries in Nigeria and other African countries to the risk of HIV spread.

At the forefront of this initiative is the National Agency for the Control of AIDS (NACA), whose Director-General, Temitope Ilori, disclosed the plan in Ilorin, Kwara State, over the weekend. Speaking at the inauguration of the Kwara Prevention of Mother-to-Child Transmission (PMTCT) and Paediatrics ART Acceleration Committee, Ilori stated that Nigeria must take decisive steps to reduce its dependency on foreign aid and ensure uninterrupted access to life-saving HIV treatments.

Ilori emphasized that the domestic production of HIV-related medical supplies was a crucial part of the government’s broader efforts to eliminate AIDS as a public health threat by 2030. She pointed out that Nigeria had long relied on external funding, particularly from PEPFAR and the Global Fund, but the Trump administration’s decision to suspend USAID support for certain global health programs had sent shockwaves through beneficiary countries, including Nigeria.

For years, Nigeria’s HIV/AIDS intervention programs have been largely dependent on international funding, with donor organizations providing antiretroviral therapy (ART), test kits, and prevention services. However, when Trump halted U.S. funding for international health initiatives, countries like Nigeria faced the looming threat of treatment disruptions. The absence of funding raised fears of drug shortages, stalled prevention programs, and an overall increase in HIV transmission rates.

The decision to establish local production of HIV treatment options is seen as a direct response to these vulnerabilities. Ilori highlighted that, despite existing HIV interventions, Nigeria still lags behind in pediatric HIV coverage, with mother-to-child transmission rates remaining high. According to the 2023 UNAIDS report, approximately 140,000 Nigerian children aged 0-14 are living with HIV, with 22,000 new infections and 15,000 AIDS-related deaths occurring annually. Despite global efforts to combat the epidemic, PMTCT and pediatric HIV coverage remain below 33 percent, a figure far from the 95 percent target.

The failure to meet these targets has been attributed to inadequate domestic funding, reliance on donor support, and gaps in program implementation. Even though international bodies like the Global Alliance have committed financial resources to the fight against AIDS, Ilori admitted that coverage remains suboptimal, emphasizing the need for government-led sustainability initiatives.

Nigeria’s HIV burden also varies significantly by region, with some local governments recording higher prevalence rates than others. In Kwara State, the HIV prevalence rate is 0.8 percent, which is lower than the national average of 1.4 percent. However, women remain disproportionately affected, with a prevalence rate of 1.3 percent compared to 0.4 percent in men. Ilori noted that while these figures show some progress, they remain unacceptable and called for targeted interventions in high-burden areas.

“Achieving an AIDS-free generation is within reach, and no child should be born HIV-positive in Kwara State,” Ilori said. She urged all partners to support the government in developing a comprehensive list of children born to HIV-positive parents, a critical step in ensuring nationwide access to pediatric ART.

Beyond Kwara, the federal government has intensified efforts to localize HIV treatment programs. The Minister of State for Health and Social Welfare, Iziaq Salako, recently established a National Acceleration Committee to oversee the expansion of HIV prevention and treatment strategies. The committee’s model is now being replicated at the state level, allowing for real-time monitoring and better program coordination.

However, the biggest challenge remains the financial sustainability of Nigeria’s HIV program. The sudden suspension of foreign aid, though partially reversed in later years, served as a wake-up call, exposing the dangers of over-reliance on external donors. Ilori revealed that in the past few days, she had received numerous calls expressing concerns about the implications of Trump’s 90-day foreign aid suspension, particularly on Nigeria’s HIV response.

“Over the past few days, I have received numerous calls regarding the implications of the 90-day foreign aid suspension on our HIV program. While we are relieved that HIV services remain exempt, this situation underscores the need for government-led sustainability efforts,” she said.

The move to produce HIV test kits and antiretroviral drugs locally is expected to lower costs, reduce dependence on volatile donor funding, and ensure that HIV-positive individuals have uninterrupted access to treatment. Experts warn, however, that success will depend on the government’s ability to invest in pharmaceutical manufacturing, enforce strict quality control measures, and strengthen supply chain management.

With over 1.9 million Nigerians currently living with HIV, the potential for spread is high. If successfully implemented, this initiative could position Nigeria as a leader in Africa’s fight against HIV/AIDS, providing a blueprint for other nations grappling with similar funding challenges.

However, health experts note that achieving this goal will require strong political commitment, increased financial investment, and continued engagement with stakeholders to ensure that the country’s HIV response remains effective, even in the face of donor uncertainties.