Making the AIDS money work: the product of corruption in HIV&AIDS response in

Nigeria
By
Onyemelukwe Akaoma.

Background of the problem

In the last decade, the HIV&AIDS epidemic has assumed an alarming dimension with
exponential increase in the rates of new infections across the globe including Nigeria.
About 33 million people are living with HIV&AIDS with 2.1 million new infections in 2007
The HIV&AIDS epidemic in Nigeria has a sero-prevalence of 4.4% with an estimated
population of about 140 million people. Nigeria is rated second after South African in the
number of people living with HIV&AIDS. This evidences the level of the epidemic burden
of new infections, care and support and mitigation of the impact in the country.

With about 22 years from the first reported case of HIV&AIDS in Nigeria, the national
response has continued to stimulate activities with the multiplied funding stream/ budget
scale up for interventions; the people are yet to feel the impact of the AIDS money
especially at the rural and community levels. The major limiting factor to the efforts to
control the spread of HIV and the increase treatment for people living with HIV&AIDS in
Nigeria is Corruption. The response with increased budgets have not paid attention
regarding to the anti-corruption mechanisms needed to ensure their proper use providing
further opportunity for corruption. Corruption experienced in HIV&AIDS prevention,
treatment and care and support are not different from the corruption in the health sector.
However, the problem is magnified because of the impact of the pandemic, the HIV
related stigma and the high cost of treatment resulting to deaths.

Issues and effect

Corruption in Nigeria especially within the HIV&AIDS National response is bedeviled with
lots of alarming practices and principles which have limited the effectiveness of the
intervention in prevention, care and treatment. The sources of corruption in HIV&AIDS in
many ways are similar to the health sector. The issues of corruption in the AIDS response
are more in the weak structures and systems of government agencies and the way
government does it business. This weakness is more in its organizational and institutional
establishment for internal control and systematic processes in areas such as procurement
which are known to be opaque and some misappropriation of funds earmarked for the
response. The corruption is seen in the weak coordinating capacity of the national and
state agencies to coordinate the response using the identified priority areas to guide
interventions among the players and stakeholders ensuring reach and coverage of the
people most affected, vulnerable and powerless. The coordinating agencies are majorly
donor fund driven and stand alone has implication in increasing corruption

The performance based disbursement has some potential for increasing accountability but
this is a wicked kind of incentive for falsified accounting and reporting. The weak
programming and coordinating capacity can as a result of required speed in disbursement
make for careless and fictitious allocation of funds and claims for activities not executed.
Cutting corners by attempting to implement programmes, influencing decision of
disbursement of funds to less competent organisations such as NGOS The national
response is characterized by corruption in the urbanization of treatment centers. Larger

African Conference on Institution, culture and corruption 2008- Akaoma 1

percentages of that need treatment live in the rural areas but many of them who are on
treatment have to travel long distances. Large number of people who need the drugs
cannot access it either because of the coverage The ARV drugs are free in many parts of
Nigeria but there are hidden charges and are yet to be comprehensive. The money for
AIDS cannot work for its people because the donor community in their processes fuel
corruption in Nigeria. In the last few years, they have increased their funding for
interventions but have not increased the capacity of staff to monitor accurate expenditure
of the funds and compliance. They are only interested in the evidence of the capacity to
spend funds (Burn Rate)

The HIV&AIDS pandemic has continued to spread in Nigeria. Women and girls are about
4 times more likely to get infected. Several factors drive the epidemic such as poverty,
powerlessness, gender based violence, stigma and discrimination, cultural and religious
tents and norms, inadequate social support systems etc. The issue of corruption has
deepened the impact of the pandemic ensuring that efforts do not yield commensurate
results. It has resulted in more deaths and production of more numbers of children
orphaned by Aids. This has increased the fact that many CSO and NGO working in the
national response see HIV&AIDS funds as free money and money for their personal gain
and enrichment. The ethnic inclination has made for the concept “fraternitization” in these
lines deepening patron-client relationship. This has made for more words that are not
matched by action.

Lessons learnt
The HIV&AIDS response in Nigeria need to develop systematic processes and accurate
anti corruption mechanism for monitoring budgets and expenditure; the coordinating
agencies capacity should be strengthening in this area. There is a need to make the
coordinating agencies multi sectoral and increase government funding. The technical
capacity of the both civil society organisations and the coordinating agencies to be
strengthened to understand the rights based perspective to HIV&AIDS response and
development. International development partners are to increase staffing capacity for
monitoring of funds. The need to involvement people in the response from the community
level will build voice for greater impact of AIDS money

Recommendation
Change in the way government does it business and the value system on Nigeria
eradicate corruption, poverty and make HIV&AIDS money work for the poor and
excluded.

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