21 March 2023

Harm Reduction Information Note – Nigeria

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Harm Reduction Information Note - Nigeria

This information note has been compiled by Harm Reduction International (HRI) in collaboration with Drug Harm Reduction Advocacy Network Nigeria (DHRAN), to support Global Fund Grant Cycle 7 processes.

Epidemiological context

  • People who inject drugs size estimate: 326,000.
  • 24% of people who inject drugs are adolescents and young people between 15-24.
  • HIV prevalence: 10.9% nationally, while as high as 23.4% in Benue.
  • Around 9% of new HIV infections per year are among people who inject drugs and their partners.
  • Self-reported prevalence of hepatitis B: 7.8% amongst people who inject drugs and 6.6% amongst high-risk drug users.
  • Self-reported prevalence of hepatitis C: 3.3% amongst people who inject drugs and 2.3% amongst high-risk drug users

HIV prevention, treatment and harm reduction for people who inject drugs

  • Harm reduction services are included in the national HIV and AIDS strategic framework 2021-2025, including opioid agonist therapy (OAT), needle and syringe programme (NSP) and outreach.
  • NSP: 312 syringes per person per year.
  • OAT: at least one OAT programme is providing methadone.
  • ART coverage among people who inject drugs living with HIV: 25%

Harm Reduction Financing

  • Harm reduction continues to depend heavily on international donors in Nigeria. PEPFAR and the Global Fund contribution account for 67% and 15% respectively to the national HIV response.
  • Out of USD 2.1 billion reported donor (Global Fund and PEPFAR) spending on HIV between 2015-2018, only USD 44 million was spent on key population programmes – which represents 2% of the total HIV expenditure.
  • The approved cost for the Global Fund supported harm reduction intervention was USD 1.96 million under the National Aligned HIV/AIDS Initiative (NAHI) for the period covering 2021-2023.
  • There is no account of domestic harm reduction funding since there has not been any commitment in this regard. The implementation of the National Drug Control Master Plan (NDCMP 2021-2025), which includes harm reduction as a strategic pillar, has not yet been operationalised.

Advocacy priorities for people who use drugs in Grant Cycle 7

  • Scale up harm reduction and HIV prevention services, including OAT and NSP.
  • Address existing gaps related to stock out and legal aid services.
  • Integration of viral hepatitis vaccination, testing and treatment services into HIV programme.
  • Integration of sexual reproductive health and rights services into HIV services.
  • Develop capacity of community-led collectives and organisations on HIV interventions for their communities.
  • Advocacy to reduce the legal barriers and increase funding for harm reduction.

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