Author: peter osalor
The general state of infrastructure across the African continent and especially sub-Saharan Africa is acutely discomfiting. With the exception of South Africa, the continent's largest economy, the entire region is bogged down by severe infrastructure deficits that have frustrated development programmes and marred growth prospects. The Southern African Development Community (SADC) countries have been relatively better off in this regard with their efforts to drive area-wide development through trade agreements, resource pooling and multi-nation collaborations. Western Africa, on the other hand, has been bereft of similar benefits due to complex past and present exigencies. As a result, the economic potential of this region has hardly been scratched.
In June this year, the World Bank approved a $1 billion loan for Nigeria to fund multiple development programmes including expansion and enhancement of the country's massively deficient power sector. An amount of $200 million was earmarked for investment in networking and technical upgrades to improve electric supply. While this concessionary, interest-free funding comes as an undoubtedly welcome development, it amounts but to a tiny fraction of Nigeria's overall investment requirement in infrastructure. In August 2008, the Nigerian Debt Management Office (DMO) revealed that the country needed at least $100 billion in investment to develop four key infrastructure areas - power, rail, roads and oil & gas. The figure was calculated to align with the ambitious national goal of taking Nigeria to the top-20 world economies by 2020. Of the four sectors mentioned, power alone would require an estimated investment of between $18 and $20 billion over the next ten years. With a current installed capacity of 6,000 MW against the total requirement of 10,000 units, only 40% of Nigerians currently have access to electricity.
The collapse of basic infrastructure and social services was set off in the 1980s, after Abuja's unhealthy dependence on oil exports decimated its agriculture and light manufacturing sectors. The static oil economy wiped out traditional and emerging livelihoods, creating rampant unemployment, poverty and degraded living standards. By 2002, per capita income was below the level for 1960, when Nigeria gained independence from British rule. In terms of infrastructure decline, power happens to be the most hardly hit, but the government readily admits severe shortfalls in a many other areas as well. For instance, the rail network is in shambles and today accounts for only 1% of national transportation1. The port service likewise suffers severe bottlenecks and inadequate capacity optimisation. The over 100,000 km long road network is in disrepair at best and barely usable at worst.
Because of Nigeria's strategic location and the abundance of its natural resources, infrastructure development in the country has pan-African relevance. The human capital of 148 million that makes Nigeria the most populous African nation is a workforce of uncharted economic potential. The country's thriving informal sector, estimated to be as high as 75% of the total economy, also conceals tremendous possibilities for inclusive growth. Rapid SME development has hence been the mainstay of successive governments since the reinstatement of civilian rule in 1999. Nigeria's ability to kick-start an enterprise revolution that will fundamentally alter its macroeconomic imbalances remains the quintessential challenge of its 2020 goal.
Infrastructure development is clearly going to be the first building block in this endeavour, and ground realities are pretty harsh as present conditions go. For Nigeria, the larger impact of infrastructure deficits is the high cost of doing business, for large corporations and small enterprises alike. Lawmakers need to draw up a comprehensive blueprint to reverse this trend in a time-bound manner. The following are two key aspects in this consideration:
o The whole of Western African receives very nominal foreign private investment in infrastructure due to a slew of reasons ranging from high foreign exchange risks to low creditworthiness. The region's subdued ability to raise debt and inclination towards infrastructure sectors with limited regulatory intervention are further obstacles. Nigeria needs to lead the way in enhancing access to equity debt as a means of attracting projects with viable private participation.
o The ability of local finance markets to fund infrastructure projects is very low across the continent. Local long-term local financing is almost non-existent except in South Africa, which has been successful in developing an indigenous capital market for consistent funding on convenient terms. The absence of similar capacity in the rest of Africa means most of it is dependent entirely on grants-in-aid and soft loans from international development agencies.
For developing African economies, increasing foreign investment on infrastructure while simultaneously developing avenues for credible local finance is a daunting task. The current Nigerian government under President UM Yar'Adua acknowledges the challenge by listing infrastructure development as a cornerstone component of the 7 Point Agenda for realisation of the 2020 goals as well as the Millennium Development targets. Some recent initiatives in this connection include the setting up of a federal mortgage bank, a housing authority and a national road maintenance agency.
That infrastructure will be the prime driver of all socio-economic development in Africa is given. What remain unclear are the ways and means that individual nations employ, and the ground effectiveness of such measures beyond official statistics and proclamations. Nigeria has the unique opportunity not only to reverse decades of economic stagnation but also to hold up an effective model for accelerated growth to the rest of the continent. The success of its long-term ambition gathers wider significance because it is bound to have a gradual spill-over effect on its immediate geography.
Article Source: http://www.articlesbase.com/economics-articles/nigerian-infrastructure-development-and-the-enterprise-revolution-an-african-perspective-3015339.html
About the Author
Peter Osalor is a multi-skilled director, chairman of trusts, proprietor and consultant. Peter Osalor has been a successful entrepreneur since 1992 when he formed Peter Osalor & Co and which has since grown to a very large client base with a turnover of millions. He is currently a fellow of the Association of Chartered Certified Accountants (ACCA) and the Institute of Chartered Accountants in Nigeria (ICAN). Peter is also a member of the Chartered Tax Advisors and the Chartered Institute of Taxation in Nigeria (CITN).
T2S:
This article was written sometime last year...however it's relevance to our present day society will remain timeless or 'dateless' as long as we continue to suffer from a complete lack of viable infrastructure.
"Growth potential is dependent on the quality of performance of infrastructure to a great extent - a fact the Chinese realised much earlier than us..." (http://www.chillibreeze.com/articles/Infrastructure-Development-and-Economic-Growth.asp)
We need to advocate for infrastructural development as a way towards truly making Nigeria one of the top 20 economies of the world by 2020. More to come...
Issues
brain drain
(1)
change
(8)
children
(1)
corruption
(2)
electricity
(1)
Emancipation
(2)
freedom
(1)
government
(1)
HIV
(1)
Hope
(1)
infratructure
(2)
innovation
(2)
leadership
(2)
mother africa
(1)
motivation
(1)
nationalism
(2)
niger-delta
(1)
nigeria
(4)
nigeria's future
(3)
nigerian issues
(4)
nigerian spirit
(2)
oil exports
(1)
patriotism
(2)
politicians
(1)
Pray for Nigeria
(2)
progress
(1)
sadc
(1)
Monday, February 28, 2011
Saturday, February 26, 2011
S.P.I.R.I.T.:Governor Tunde Fashola- Spirited leadership
BABATUNDE RAJI FASHOLA (SAN)
Governor of Lagos State, Nigeria
Governor of Lagos State, Nigeria
Governor of Lagos State, Mr. Babatunde Raji Fashola (SAN) is the recipient of the 2009 Yikzak Rabin Centre for African Development Governor of the Decade for Peace Award and the recipient of the 2010 Award of Excellence in Leadership of the Martin Luther King Jnr. Foundation.
He is the recipient of the 2009 Good Governance Award from the United Kingdom-based African Business Magazine. Here in Nigeria, he is The Guardian, The Vanguard and The Sun newspapers' Man of The Year for 2009.
Both nationally and internationally, he is acclaimed as one of the bright hopes for the future of Nigeria; one of the very progressive Governors determined to reclaim Nigeria's past glories through competent and transparent leadership.
In the past three and a half years, Mr. Fashola (SAN), has demonstrated excellence and uncommon commitment to his avowed pledge to lead the change that would transform Lagos into Africa's model mega-city.
Some of the key projects which his dynamic and proactive business-minded skills have inspired and advanced include the Eko Atlantic City project, the 10-lane Lagos-Badagry Expressway, the expansion of the Lekki-Epe Expressway, the Lekki Free Zone, the Bus Rapid Transit System, massive Infrastructure Renewal in all parts of the State, that has won the State honours from as far as Australia for undertaking the fastest infrastructure renewal ever in Africa, and the establishment of the Security Trust Fund.
Some of the key projects which his dynamic and proactive business-minded skills have inspired and advanced include the Eko Atlantic City project, the 10-lane Lagos-Badagry Expressway, the expansion of the Lekki-Epe Expressway, the Lekki Free Zone, the Bus Rapid Transit System, massive Infrastructure Renewal in all parts of the State, that has won the State honours from as far as Australia for undertaking the fastest infrastructure renewal ever in Africa, and the establishment of the Security Trust Fund.
His other achievements include Environmental Regeneration that helped reduce violent crimes by over 70% in 1 year; the massive cleanup of Oshodi and other metropolitan open sores once regarded as irredeemable. Concrete steps have also been taken towards improving Agriculture and Food Security among many others.
A passionate lover of children and the youth who represent the future of our continent, Governor Fashola has, in the three and a half years of his tenure, embarked on projects aimed at improving their lives and the opportunities open to children and youths in the State. They include, the construction of Maternal and Childcare Centres across the State to improve maternal and child health, immunization against polio and other child-killer diseases, the revitalization of voluntary uniformed organizations in the State's public schools to build character and leadership qualities in children and provide a choice away from street gangs, renovation and rehabilitation of classrooms as well as the building of new structures and the provision of educational facilities including desks and chairs.
Others are the provision of free uniforms and textbooks to pupils and students in public schools, provision of Summer Vacation jobs for students, the formation of youth clubs and societies in schools, including Climate Change Clubs and the Be Road Friendly Club designed to inculcate environmental and road traffic awareness respectively in children at an early age. These have been projected at making school more attractive to children; the school should also become that real centre of a well rounded learning.
The Governor, during his first term in office, has also undertaken the construction of mini-stadia with the provision of sporting facilities to engage the energy of youths in the State in productive and responsible ventures. These were accompanied by establishment of Vocational and Skill Acquisition Centres that has graduated over 20,000 young people and provided jobs for them.
Born on June 28, 1963 in Lagos, Mr. Babatunde Raji Fashola (SAN) is a truly made in Nigeria product. He obtained his First School Leaving Certificate [FSLC] from the Sunny Fields Primary School, Adelabu Surulere, Lagos, after which he proceeded to Birch Freeman High School, Surulere, Lagos and later Igbobi College, Yaba from where he acquired the West African School Certificate [WASC]. He, thereafter, went to the University of Benin, Benin City and graduated with a Bachelor of Laws [LLB Hons] degree in 1987. He was called to the Nigeria Bar in November 1988 after undertaking the statutory training for Barristers and Solicitors.
For the mandatory National Youth Service Corps [NYSC] programme [1988-1989], he served in Benin, the former Bendel State now Edo State. His flourishing private legal practice, running into nearly fifteen years, saw him acquiring appreciable expertise and vast experience in such areas as Litigation, Intellectual Property [registration of trademarks], Commercial Law, Mergers, Acquisitions, Right of Issues, Ownership of Shares and Equity of Corporations, as well as Land Disputes and Chieftaincy Matters.
In the course of his distinguished legal career at Sofunde, Osakwe, Ogundipe and Belgore; the law firm of K.O.Tinubu & Company and as Managing Partner, Lead Counsel, Babatunde Raji Fashola successfully pleaded many cases at High Courts, various divisions of the Court of Appeal and the Supreme Court, and to cap a successful legal career, he was elevated to the class of Nigerian Elite Lawyers in August 2004 when he was conferred with the rank of Senior Advocate of Nigeria [SAN], a leadership position of the Nigerian Bar and the nation's highest legal distinction and honour for lawyers.
He was appointed Chief of Staff by the former Governor of Lagos State [Governor Emeritus], Asiwaju Bola Ahmed Tinubu who he later succeeded in office and served from August 16, 2002 to November 6, 2006, during which time he served as Member, State Tenders Board; Member, State Executive Council, Member, State Treasury Board, and Member, State Security Council amongst several other Ad-Hoc Committees/Panels. With the experiences he garnered he resigned voluntarily to contest for the Office of Governor of Lagos State under the platform of Action Congress [AC] Party now Action Congress of Nigeria.
With his victory at the April 14, 2007 Governorship election, he was sworn in as Governor of Lagos State on May 29, 2007. Since then, Governor Babatunde Raji Fashola (SAN) has been able to bring to bear on the governance of Lagos State all the invaluable experiences he acquired over the years. Given the spate of achievements recorded so far [May 2007-2010] by the Fashola Administration, pundits and colleagues alike are wont to describe him as the 'primus inter pares' in Nigeria in the 5th Republic...
Culled from tundefashola.com.
I share this today as an example of the S.P.I.R.I.T. Nigeria needs for transformation. Here is an individual dedicated to SERVICE, who is PASSIONATE; has INTEGRITY; shows RESPECT for his office and in turn is respected; his leadership style is hinged on INNOVATION and executed by TEAMWORK.
This is the new Nigerian SPIRIT!
A new Naija S.P.I.R.I.T.
I have been doing a lot of reading recently, specifically doing case studies of nations that through certain ideologies, strategies and efforts, have transformed themselves from third world countries to powerful nations that are the pride of their respective geographical regions.
To put it briefly, I have come to see that what Nigerians need is a new S.P.I.R.I.T: We need inculcate the values of Service, Passion, Integrity, Respect. Innovation and Teamwork!
To put it briefly, I have come to see that what Nigerians need is a new S.P.I.R.I.T: We need inculcate the values of Service, Passion, Integrity, Respect. Innovation and Teamwork!
I believe (and so can you) that if youths of this country can imbibe these qualities and apply them in all nation and society building endeavors, we will begin to see the dawn of a new era of development.
Don't just read this but take some time to actually think it through...Service. Passion. Integrity. Respect. Innovation. Teamwork....In our businesses, (selling pure water, garri or real estate), careers, everyday interactions, politics...political aspirations and negotiations, leadership positions...If we begin to integrate this S.P.I.R.I.T into all we do...well,...enough said for now.
Don't just read this but take some time to actually think it through...Service. Passion. Integrity. Respect. Innovation. Teamwork....In our businesses, (selling pure water, garri or real estate), careers, everyday interactions, politics...political aspirations and negotiations, leadership positions...If we begin to integrate this S.P.I.R.I.T into all we do...well,...enough said for now.
Stay tuned to this.... OK let me call it channel. In the coming days (or even hours because e get as the tin dey do me), I will be sharing more of my thoughts on this new S.P.I.R.I.T. Of course as usual, your thoughts and comments (on facebook and/or this blog) are most welcome
Saturday, February 19, 2011
A New Nigeria
Nigeria’s fortunes are my meditation
The future of her population
Endangered by deep corruption
By widespread moral pollution
Do we need a revolution?
Like the Egyptian Insurrection?
For our collective liberation
And comprehensive emancipation
For our leaders lack direction
Their lack of vision our oppression
Their political altercations
Only deepens our repression
In my earnest estimation
We need a cure for this infection
A new moral calibration
A rejuvenated constitution
We need fresh illumination
A new vision of a our nation
An end to this suppression
A new Nigerian expression
Prosperity for our population
Societal revitalization
A warranty of restoration
Hope for our generation
Shawn Asala © Jan 2011
Friday, February 18, 2011
NATIONALISM
Nationalism. Patriotism. What do these words mean to the average brother on the street? I can picture myself getting on the road with a microphone and camera operator and pestering an area boy with these questions:
“Young man, are you a patriot? What does nationalism mean to you?”
Firstly, he will look nonplussed and suspicious, thinking to himself, “Is this guy trying to embarrass me?” That is because unfortunately, the average guy on the street may not be educated enough to understand the import of such words. Next, he will probably get exasperated.
“My guy, you dey talk patriotism. Wetin this country don do for me? Ehn? Abeg leave story for monkey jo. See me dey hustle for the past how many days now, still pepper neva enter pocket. Abi you wan supply? Ehn? Wetin you carry? Cooperate oh...”
At that stage, I’d have to jam my tail between my legs and bolt. In the course of the week of writing this piece, I spoke to a few friends:
“I’d like to ask you a question. What do you think of Nigeria generally?” I’m talking to a fresh graduate who has been actively job-hunting for the past five months.
“What do you mean? Can you be more specific?”
“Okay I mean is there a problem in this country from your own point of view?”
“Oh well I’d say there is a problem of course, but first I’d like to say that I believe in this country. In fact, I get into a lot of arguments with my friends over this Nigeria issue, because whenever I talk this way they wonder if I’m sick or something!”
“Why?” I ask.
“They don’t believe anything good can come out of this country. They don’t agree that any progress is being made. Yes, I concede that things could definitely be better because we are a country blessed with a lot of underutilized potential. However, the problem I have with many Nigerians is that we are so negative. The average Nigerian has nothing good to say about this country...”
We talked and talked. I was pleased to find someone who believes in a greater Nigeria. A patriot. There are quite a few of us out there you know? However, I admit, it’s rather hard keeping your eyes to the hills in a country like this; where one and one is not equal to two; where sh#t happens, and on a very regular basis for that matter. Nevertheless, we must ask ourselves some pertinent questions: Is Nigeria an accident? Is the entire mineral and oil deposits in this land some freak of nature? The potentials we have in both human and material resources, are they a mistake? Are you and I Nigerians only because we got rejected in some other land where the grass appears to be greener?
I believe that we are inhabitants of this great nation for some good reason. I believe citizens of the ‘land where the grass is greener’ don’t have two heads. I believe that in spite of the malfunctioning system of operation in this country, we do have what it takes to raise the standard of living and make Naija a mo’ better place for all of us. Do y’all agree with me or am I alone? I think not.
So where do we start from? How do I, with my tiny slingshot, take this giant Goliath down? I asked another friend this same question:
“Well ah, that’s a very nice question. I’ll start by saying there’s a positive solution and a negative one. I’ll begin with the negative.” (I wonder why)
He continued, “the negative solution is to stage a revolution. Let’s rout up the thieving bastards and burn them alive at the stakes. Though not before making sure they return all the loot they’ve stolen over the years. It worked in Russia abi?”
True or false, I was suddenly eager to hear about the second solution.
“Well the second is to educate the minds of the people; help them to understand their rights and potentials.”
Now that’s more like it.
Surely, it is an understatement to say that taking this nation to the status of maximized potential is a gargantuan task. Nevertheless, the popular cliché is still true: “Rome wasn’t built in a day”. I think it is the Chinese that have a proverb that goes, “the journey of a thousand miles begins with a step”. The issue at stake here is persistence in doing and believing in what is right. Are we willing to believe in a greater Nigeria? God gave this country to us. Are we willing to take responsibility for what is ours and do our best to utilize our assets maximally and positively? Are we willing to forget the past and be more mindful of what we can achieve if we set our minds to it?
Picture a NEPA that really works, giving us uninterrupted power supply. Who is to benefit from that? Of course, everyone. Including you. Imagine clean wide roads, reasonably priced utilities, absence of university strikes and availability of quality health care at costs affordable to the common man. Visualize a respectable and efficient police force and more employment opportunities for fresh graduates. Admit it, who will benefit from all of this were it to come true right now? Everyone including you. These seemingly lofty things are attainable, though not without a struggle. We do not lose anything by believing that it is possible to get there. It’s simply a choice: faith or pessimism.
Each time I go to our nation’s capital, I feel like I’m in a heaven of sorts. The wide roads and relatively smooth traffic; beautiful sights, operational traffic lights, exotic cars and pretty faces. Ahh. Imagine if every part of the motherland was like this. Fantasy! I hear you say. Most definitely. Because when I get to places like Oja Oba in Ilorin, Kwara state, I’m brutally brought back to reality. This is Nigeria in the raw, the uncut version. Here kids less than two years of age eat cuts of sugar cane for breakfast and crawl on the filthy floor with goats and dogs. Here pot-bellied policemen stand blocking the flow of traffic and causing a hold-up as they extort bus drivers for their ‘take-home pay’. A place so crowded, there is no difference between human and automobile traffic. Whenever I find myself in such places, the thought that comes to mind is this: “Mr. President, there’s still so much work to be done. We haven’t started yet.”
Nonetheless, we must realize that the task ahead is not for the government alone. It starts with the individual Nigerian: you and I. If every Nigerian can summon up the courage to believe in a greater Nigeria and work towards the ideal by doing their best, not just for themselves but for their fellow citizens as well, then there is hope. Thankfully, we are all beginning to see now that the economic change we desperately need lies just as much in the hand of the private sector as it does in the hands of the government. That is tantamount to saying that “think not of what your country can do for you, but what you can do for your country”.
I’ll end this piece with a quote from a man who, through personal sacrifice, persistence and unflinching faith, helped bring fulfillment to the dreams of his people:
Firstly, he will look nonplussed and suspicious, thinking to himself, “Is this guy trying to embarrass me?” That is because unfortunately, the average guy on the street may not be educated enough to understand the import of such words. Next, he will probably get exasperated.
“My guy, you dey talk patriotism. Wetin this country don do for me? Ehn? Abeg leave story for monkey jo. See me dey hustle for the past how many days now, still pepper neva enter pocket. Abi you wan supply? Ehn? Wetin you carry? Cooperate oh...”
At that stage, I’d have to jam my tail between my legs and bolt. In the course of the week of writing this piece, I spoke to a few friends:
“I’d like to ask you a question. What do you think of Nigeria generally?” I’m talking to a fresh graduate who has been actively job-hunting for the past five months.
“What do you mean? Can you be more specific?”
“Okay I mean is there a problem in this country from your own point of view?”
“Oh well I’d say there is a problem of course, but first I’d like to say that I believe in this country. In fact, I get into a lot of arguments with my friends over this Nigeria issue, because whenever I talk this way they wonder if I’m sick or something!”
“Why?” I ask.
“They don’t believe anything good can come out of this country. They don’t agree that any progress is being made. Yes, I concede that things could definitely be better because we are a country blessed with a lot of underutilized potential. However, the problem I have with many Nigerians is that we are so negative. The average Nigerian has nothing good to say about this country...”
We talked and talked. I was pleased to find someone who believes in a greater Nigeria. A patriot. There are quite a few of us out there you know? However, I admit, it’s rather hard keeping your eyes to the hills in a country like this; where one and one is not equal to two; where sh#t happens, and on a very regular basis for that matter. Nevertheless, we must ask ourselves some pertinent questions: Is Nigeria an accident? Is the entire mineral and oil deposits in this land some freak of nature? The potentials we have in both human and material resources, are they a mistake? Are you and I Nigerians only because we got rejected in some other land where the grass appears to be greener?
I believe that we are inhabitants of this great nation for some good reason. I believe citizens of the ‘land where the grass is greener’ don’t have two heads. I believe that in spite of the malfunctioning system of operation in this country, we do have what it takes to raise the standard of living and make Naija a mo’ better place for all of us. Do y’all agree with me or am I alone? I think not.
So where do we start from? How do I, with my tiny slingshot, take this giant Goliath down? I asked another friend this same question:
“Well ah, that’s a very nice question. I’ll start by saying there’s a positive solution and a negative one. I’ll begin with the negative.” (I wonder why)
He continued, “the negative solution is to stage a revolution. Let’s rout up the thieving bastards and burn them alive at the stakes. Though not before making sure they return all the loot they’ve stolen over the years. It worked in Russia abi?”
True or false, I was suddenly eager to hear about the second solution.
“Well the second is to educate the minds of the people; help them to understand their rights and potentials.”
Now that’s more like it.
Surely, it is an understatement to say that taking this nation to the status of maximized potential is a gargantuan task. Nevertheless, the popular cliché is still true: “Rome wasn’t built in a day”. I think it is the Chinese that have a proverb that goes, “the journey of a thousand miles begins with a step”. The issue at stake here is persistence in doing and believing in what is right. Are we willing to believe in a greater Nigeria? God gave this country to us. Are we willing to take responsibility for what is ours and do our best to utilize our assets maximally and positively? Are we willing to forget the past and be more mindful of what we can achieve if we set our minds to it?
Picture a NEPA that really works, giving us uninterrupted power supply. Who is to benefit from that? Of course, everyone. Including you. Imagine clean wide roads, reasonably priced utilities, absence of university strikes and availability of quality health care at costs affordable to the common man. Visualize a respectable and efficient police force and more employment opportunities for fresh graduates. Admit it, who will benefit from all of this were it to come true right now? Everyone including you. These seemingly lofty things are attainable, though not without a struggle. We do not lose anything by believing that it is possible to get there. It’s simply a choice: faith or pessimism.
Each time I go to our nation’s capital, I feel like I’m in a heaven of sorts. The wide roads and relatively smooth traffic; beautiful sights, operational traffic lights, exotic cars and pretty faces. Ahh. Imagine if every part of the motherland was like this. Fantasy! I hear you say. Most definitely. Because when I get to places like Oja Oba in Ilorin, Kwara state, I’m brutally brought back to reality. This is Nigeria in the raw, the uncut version. Here kids less than two years of age eat cuts of sugar cane for breakfast and crawl on the filthy floor with goats and dogs. Here pot-bellied policemen stand blocking the flow of traffic and causing a hold-up as they extort bus drivers for their ‘take-home pay’. A place so crowded, there is no difference between human and automobile traffic. Whenever I find myself in such places, the thought that comes to mind is this: “Mr. President, there’s still so much work to be done. We haven’t started yet.”
Nonetheless, we must realize that the task ahead is not for the government alone. It starts with the individual Nigerian: you and I. If every Nigerian can summon up the courage to believe in a greater Nigeria and work towards the ideal by doing their best, not just for themselves but for their fellow citizens as well, then there is hope. Thankfully, we are all beginning to see now that the economic change we desperately need lies just as much in the hand of the private sector as it does in the hands of the government. That is tantamount to saying that “think not of what your country can do for you, but what you can do for your country”.
I’ll end this piece with a quote from a man who, through personal sacrifice, persistence and unflinching faith, helped bring fulfillment to the dreams of his people:
"There is no easy walk to freedom anywhere, and many of us will have to pass through the valley of the shadow of death again and again before we reach the mountaintop of our desires."
Nelson Mandela
No easy walk to freedom…Nigerians! We must do what it takes to take this country to greater heights!
Thanks for dropping by.
Thursday, February 17, 2011
The Future with HIV
The diagnosis of HIV is not an easy one, because it brings along with it a kaleidoscope of emotional and psychological trauma characterized by fear, denial, discouragement, guilt and hopelessness. However with the advent of life-saving medications called Antiretroviral drugs (ARVs), people with HIV can be assured of a future. Not everyone diagnosed with HIV infection is eligible to start taking ARVs because in some, their immune system (the system of the body that helps fight disease and maintain health) has not been compromised by the virus and they are able to remain healthy without drugs. The catch however is that anyone placed on ARVs must be 100% adherent, i.e. must take all of his or her prescribed ARV medications, to achieve total suppression of the virus.
The virus in most cases responds to the ARVs and its activities are more or less paralyzed in the presence of adequate blood levels of the drug. Unfortunately some strains of the virus become resistant especially when the blood levels of the drug become suboptimal for any reason and the virus is able to multiply in the presence of the drug. Some of the reasons include poor adherence to the drugs, fake or expired drugs and stock outs of drugs at clinic pharmacies so that people on ARVs are unable to get their next supply of drugs.
HIV-positive patients about to start antiretroviral treatment are warned not to skip even the occasional dose of their medication because of the virus' ability to mutate rapidly and become drug resistant;
When one contracts a strain of HIV resistant to some life-prolonging medicines, treatment options become limited. A recent study done in five African countries found that transmitted HIV drug resistance may be on the rise in Africa. ¹
The sad fact is that a number of people who are yet to start treatment with ARVs may already be infected with a resistant strain of the virus and therefore may be doomed to fail their treatment from the outset.²
If resistant strains of HIV proliferate and spread among our population, more people will begin to fail their treatment and the number of deaths due to HIV may begin to increase.
So how do we tackle this issue and ensure that the gains we have achieved in successfully treating HIV do not become reversed in the near future?
Governments and leaders in the health sector need to continue to pay due attention to HIV treatment programs and ensure regular drugs supplies for all clients on ARVs. It would also be very helpful if the tests needed to detect drug resistance are made widely available and cheap. If a patient is failing treatment, doctors mainly rely on viral load (a measure of the amount of HIV in the blood) and CD4 count tests (a measure of immune system strength) to determine whether they may be failing to respond to first line ARVs and need to be switched to second-line drugs. Generally speaking, the availability of viral load testing in African countries is very limited, and patients are kept on first-line treatment long after it becomes useless.
Governments should therefore persist in showing commitment to making such tests available, if possible without cost, so that doctors can monitor resistance and treatment failure much more effectively.
Pharmacists need to be trained and retrained on the essence of ensuring a functional drugs and commodity supply chain systems, through proper and timely reporting. They should also ensure that clients are not given expired drugs. Doctors, nurses and adherence counselors need to be equipped with knowledge and counseling skills to encourage their clients to be adherent to ARV drugs.
All people on ARVs should be constantly reminded of the importance of taking 100% of their drugs all the time according to prescribed dosages. It is not easy to take drugs for 5 days to treat a mild chest infection, how much more taking ARVs for life. Therefore people on ARVs should be empathized with and supported to ensure that they do not miss their medications.
Employers should be willing to allow their HIV positive employees to go to their clinics on appointed days and pick up their drugs. During public holidays, hospital staff should make arrangements to ensure that clients who run out of drugs during the holidays can get replenishment.
If an HIV positive person falls sick and has to be admitted, caregivers must ensure that even while on admission, the person has access to his ARVs. And in facilities offering HIV treatment services, any client who fails to come for his drugs or clinical consultations at the appointed time should be tracked and monitored closely so that he or she can be supported to take ARVs continuously.
All these strategies and procedures are important to ensure that we curb that ravaging effects of HIV. If HIV is allowed to develop resistant strains because of irresponsible HIV/AIDS treatment infrastructure and systems, the eventual result will be that resistant forms of HIV that do not respond to current life-saving drugs will spread among us.
In real life terms, the scenario will look like this:
A young man who is HIV positive has an appointment to see the doctor and pick up his next months supply of drugs on Monday. His current supply of drugs will run out by Monday evening. However Monday and Tuesday have been declared public holidays and when he gets to the facility, he finds that the HIV clinic and pharmacy are closed. By Wednesday morning he has already missed 2 or 3 doses of his ARVs. The reduced levels of the ARVs in his blood stream allow the virus to begin to multiply and in so doing, they develop mutations that enable them to become active even in the presence of ARVs. The virus becomes resistant. This resistant strain continues to multiply and their population in his blood increases over time.
During one night of reckless abandon he has unprotected sex with a young lady and she becomes infected. Two years later, her immune system becomes severely depressed by the virus and she starts falling sick. After initial tests the doctor recommends that she begins ARV treatment. However because she is infected with resistant HIV, she does not respond to treatment and she gets even sicker. Unfortunately, tests to detect resistant strains of the virus are not routinely available in most general hospitals. She is referred to a special center for the test but it’s going to cost her up to 200,000 naira.
And so the story goes…
In another case, the fellow on ARVs could have missed his doses because he was not properly counseled on the importance of not missing his medications. Or he may just be non chalant and irresponsible regarding his medications. At the end of the day, what happens is that the virus wins the battle and all efforts to treat and save both him and the poor young girl are in vain.
When I look at the future and I think about HIV, what do I see? I hope to see a future where resistant strains of the virus are few and detected early. I hope to see a future where our hospitals and clinics are equipped to be able to carry out important tests at affordable costs. I hope to see a committed and responsible government that cares about its people, especially those living with HIV and AIDS. I hope that in the future, my children, and their children, will grow up safe and healthy, in an environment that is coordinated and equipped with knowledge and strategies to win the fight against HIV.
That is the future I hope to see.
References:
¹ http://www.liebertonline.com/doi/full/10.1089/aid.2010.0030
² http://www.plusnews.org/Report.aspx?ReportId=90431
The virus in most cases responds to the ARVs and its activities are more or less paralyzed in the presence of adequate blood levels of the drug. Unfortunately some strains of the virus become resistant especially when the blood levels of the drug become suboptimal for any reason and the virus is able to multiply in the presence of the drug. Some of the reasons include poor adherence to the drugs, fake or expired drugs and stock outs of drugs at clinic pharmacies so that people on ARVs are unable to get their next supply of drugs.
HIV-positive patients about to start antiretroviral treatment are warned not to skip even the occasional dose of their medication because of the virus' ability to mutate rapidly and become drug resistant;
When one contracts a strain of HIV resistant to some life-prolonging medicines, treatment options become limited. A recent study done in five African countries found that transmitted HIV drug resistance may be on the rise in Africa. ¹
The sad fact is that a number of people who are yet to start treatment with ARVs may already be infected with a resistant strain of the virus and therefore may be doomed to fail their treatment from the outset.²
If resistant strains of HIV proliferate and spread among our population, more people will begin to fail their treatment and the number of deaths due to HIV may begin to increase.
So how do we tackle this issue and ensure that the gains we have achieved in successfully treating HIV do not become reversed in the near future?
Governments and leaders in the health sector need to continue to pay due attention to HIV treatment programs and ensure regular drugs supplies for all clients on ARVs. It would also be very helpful if the tests needed to detect drug resistance are made widely available and cheap. If a patient is failing treatment, doctors mainly rely on viral load (a measure of the amount of HIV in the blood) and CD4 count tests (a measure of immune system strength) to determine whether they may be failing to respond to first line ARVs and need to be switched to second-line drugs. Generally speaking, the availability of viral load testing in African countries is very limited, and patients are kept on first-line treatment long after it becomes useless.
Governments should therefore persist in showing commitment to making such tests available, if possible without cost, so that doctors can monitor resistance and treatment failure much more effectively.
Pharmacists need to be trained and retrained on the essence of ensuring a functional drugs and commodity supply chain systems, through proper and timely reporting. They should also ensure that clients are not given expired drugs. Doctors, nurses and adherence counselors need to be equipped with knowledge and counseling skills to encourage their clients to be adherent to ARV drugs.
All people on ARVs should be constantly reminded of the importance of taking 100% of their drugs all the time according to prescribed dosages. It is not easy to take drugs for 5 days to treat a mild chest infection, how much more taking ARVs for life. Therefore people on ARVs should be empathized with and supported to ensure that they do not miss their medications.
Employers should be willing to allow their HIV positive employees to go to their clinics on appointed days and pick up their drugs. During public holidays, hospital staff should make arrangements to ensure that clients who run out of drugs during the holidays can get replenishment.
If an HIV positive person falls sick and has to be admitted, caregivers must ensure that even while on admission, the person has access to his ARVs. And in facilities offering HIV treatment services, any client who fails to come for his drugs or clinical consultations at the appointed time should be tracked and monitored closely so that he or she can be supported to take ARVs continuously.
All these strategies and procedures are important to ensure that we curb that ravaging effects of HIV. If HIV is allowed to develop resistant strains because of irresponsible HIV/AIDS treatment infrastructure and systems, the eventual result will be that resistant forms of HIV that do not respond to current life-saving drugs will spread among us.
In real life terms, the scenario will look like this:
A young man who is HIV positive has an appointment to see the doctor and pick up his next months supply of drugs on Monday. His current supply of drugs will run out by Monday evening. However Monday and Tuesday have been declared public holidays and when he gets to the facility, he finds that the HIV clinic and pharmacy are closed. By Wednesday morning he has already missed 2 or 3 doses of his ARVs. The reduced levels of the ARVs in his blood stream allow the virus to begin to multiply and in so doing, they develop mutations that enable them to become active even in the presence of ARVs. The virus becomes resistant. This resistant strain continues to multiply and their population in his blood increases over time.
During one night of reckless abandon he has unprotected sex with a young lady and she becomes infected. Two years later, her immune system becomes severely depressed by the virus and she starts falling sick. After initial tests the doctor recommends that she begins ARV treatment. However because she is infected with resistant HIV, she does not respond to treatment and she gets even sicker. Unfortunately, tests to detect resistant strains of the virus are not routinely available in most general hospitals. She is referred to a special center for the test but it’s going to cost her up to 200,000 naira.
And so the story goes…
In another case, the fellow on ARVs could have missed his doses because he was not properly counseled on the importance of not missing his medications. Or he may just be non chalant and irresponsible regarding his medications. At the end of the day, what happens is that the virus wins the battle and all efforts to treat and save both him and the poor young girl are in vain.
When I look at the future and I think about HIV, what do I see? I hope to see a future where resistant strains of the virus are few and detected early. I hope to see a future where our hospitals and clinics are equipped to be able to carry out important tests at affordable costs. I hope to see a committed and responsible government that cares about its people, especially those living with HIV and AIDS. I hope that in the future, my children, and their children, will grow up safe and healthy, in an environment that is coordinated and equipped with knowledge and strategies to win the fight against HIV.
That is the future I hope to see.
References:
¹ http://www.liebertonline.com/doi/full/10.1089/aid.2010.0030
² http://www.plusnews.org/Report.aspx?ReportId=90431
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