The Nigerian government will start providing antiretroviral treatment to 15,000 individuals already diagnosed with AIDS in September after an agreement with the Indian antiretroviral manufacturer CIPLA for provision of a triple drug combination at $350 per year.
The plan is one of the most ambitious attempts so far to make antiretroviral drugs available in resource poor and middle income countries. Nigeria is estimated to have between 2 and 4 million people living with HIV, and the initial programme will target 5,000 children and 10,000 adults, who will receive triple combination therapy in the form of either three tablets twice daily or one tablet twice daily, according to a Reuters report. The response to therapy will be monitored, and therapy will only be administered via teaching hospitals.
Patients will be asked to contribute 20% of the cost - around $8 a year - a figure considered affordable. The initial outlay on drugs will total just over $5 million, out of a total loan of $90 million given by the World Bank to support Nigeria's Emergency AIDS Action Plan.
Brazil, the only other country to follow the generic route for provision of antiretroviral treatment, has been able to make treatment available for free. In Botswana, the goverment is also making antiretroviral treatment freely available with support from the Gates Foundation and drug donations from Merck (manufacturer of indinavir and efavirenz). In Nigeria, diagnostics and monitoring of treatment response will be funded by the Ford Foundation.