In Mr. Anti-corruption on point?

 

A RECENT issue of The Economist examined the presidential bid of Nuhu Ribadu, Nigeria’s former anti-corruption chief. Mr Ribadu made his name as the first head of Nigeria’s Economic and Financial Crimes Commission (EFCC) in 2003. In this role, he pursued politicians and civil servants who were embezzling the energy revenues of Africa’s biggest oil and gas producer 

http://www.economist.com/blogs/baobab/2010/11/interview_nihu_ribadu

An interview with Nigeria's Mr Anti-Corruption

Nov 12th 2010, 16:23 by S.A. | LAGOS 

Mr Ribadu’s fortunes dipped when Umaru Yar’Adua took office as president in 2007. The sleazebuster was sidelined and later fled the country, returning only after Mr Yar’Adua’s death in May this year. He now hopes to run for the top job himself in elections due in early 2011.
Baobab talked to Mr Ribadu about whether he would be able to run a clean campaign in Nigeria’s often murky political scene.
Baobab: Why have you decided to run for president next year?
Nuhu Ribadu: I understand now that to bring about change I need political power at the highest level. That means the presidency. I have worked under a president, and many say we did a good job at the EFCC, but when change came [and a new president took office] all our work was destroyed. It was all reversed.”
Baobab: How will you use presidential power to continue your fight against corruption?
NR: Just appointing me will be half the answer. When people see me, they will sit up and know that the era of corruption is over. On the practical level, I will run a transparent government that publishes accounts online. I will create “whistleblower laws” to protect the identities of those who expose corruption. I will reform the police and the judiciary.
Corruption causes all the problems that we have here. It causes the poverty and the insecurity. And there is no one better qualified to address the problem of corruption in this country than me.

(True2Society: Let me interrupt at this point; a bold claim here by Mr. Ribadu wouldn't you say?)

Baobab: Nigerian political campaigns are costly affairs that often rely on the sponsorship of unsavoury characters. Can you run a clean campaign in a dirty system? For example, will you probe your sponsors to find out the sources of their wealth?
NR: Everything about me has always been clean and this will be a clean campaign...in any case, I will not need as much money as other parties because I am not going to bribe anyone. My campaign is about winning over people with my ideas, not my money.
But I will not probe anybody. I am not the EFCC chairman here - I am a politician who is trying to get people to support me. If money is coming to change a system that needs change, why should [the source] matter? (T2S: Once again I interrupt. For someone who is supposed to be the nemesis of corruption, why wouldn't the source of money used for your political campaign matter? It could certainly be the cause of your downfall, if your enemies funded your campaign with money stolen from the national treasury, and then turn around and say you are an accomplice...Hmmm. I wonder)  Why try to destroy this opportunity?
Baobab: You have chosen to run against the ruling People's Democratic Party with the Action Congress of Nigeria (ACN). Some Nigerian are raising eyebrows at this choice. Bola Tinubu, one of the ACN’s most powerful members, has been under EFCC investigation for years. Does this concern you?
NR: You should not worry about individuals when you are working on a project of this magnitude. It might affect the outcome...I am convinced that the mission we are out to do is not about an individual.
Baobab: Your critics also note that you have never held political office before. Why not serve as a senator or governor for one term, and then run for president in 2015?
NR: We can’t wait for 2015. Nigeria's problems must be arrested immediately. There is no way we can allow this mess to continue. Also, for the first time, the ruling party is in real trouble. Goodluck Jonathan [the incumbent] is from a very small ethnic group...Sadly, even if he were the best person for the job, northern Nigeria would never accept it. He is not electable. 
(T2S: It just amazes me the way we can't do politics in Nigeria without taking a shot at the opposition. I though he just said a few sentences ago that his mission is not about individuals but about ideas???)

In any case, I posted this today because I was just wondering about the candidates presenting themselves to rule this nation for the next four years. I don't see any bright lights on the horizon when I think about that. However that is not to say that change cannot come through one of these individuals. Indeed Ribadu has earned some degree of respect from his exploits in EFCC. He is probably a good anti-corruption crusader but a poor politician (hey, just my amateur opinion).  Let us just hope, pray, wait and see...

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

Do it for the children

The only thing Africa has left is the future.
Marita Golden (1950 - )
U.S. writer and teacher.
A Woman's Place
Microsoft ® Encarta ® 2007. © 1993-2006 Microsoft Corporation. All rights reserved.

Children, they say, are the future. Because the future belongs to them. However they can only grow up to meet whatever we leave behind for them when we die.

The decisions we make today determine the future we meet tomorrow. In a certain movie I watched recently, a profound statement was made- “there is no such thing as fate. Only choices…” In other words, the real issue is not what is meant to be (fate), but the decisions we make. The choices we make today determine our fate. But not only ours, but the fate of our children also. We have all heard of parents leaving behind for their children either great wealth, or conversely, great debt.

Many of us grew up to live with the consequences of our fathers’ irresponsible lifestyles. Or our mothers neglect. It is indeed a thing of sorrow to see our children suffer because we made wrong decisions.

This calls for us as members of this present generation to begin to build a better Nigeria for our children to enjoy. Let them grow up to meet a better socioeconomic system that guarantees a better standard of living.

Talking about health for instance, in particular HIV, how pitiful it will be to have children born with the deadly virus. But that will be the case if we do not take heed to the clarion call for responsible sexuality.

For those of us clamoring for a revolution in Nigeria, the benefit of succeeding in such a revolution is not just a better life for ourselves but also for our unborn seeds.

So if your life is just the way you want it right now and you find yourself being dulled into complacency and nonchalance about the current state of Nigerian affairs, well, I urge you to wake up. Do something to make things better. At least do it for the children.