Health
Donor cuts, govt inaction negatively impact HIV patients in Rivers, Akwa Ibom
This is the final part of a three-part series. You can read the first part here and the second part here.
Long before the gradual withdrawal of international HIV funding exposed the fragility of Nigeria’s HIV response, Akwa Ibom and Rivers states had enacted laws intended to prevent such a crisis.
The laws recognised that donor assistance would not last forever and envisaged a future in which governors provided political leadership, governments financed programmes from domestic resources, local councils coordinated community interventions, and legal protections encouraged people living with HIV to seek treatment without fear of discrimination.
On paper, the laws offered a blueprint for sustainability. However, a PREMIUM TIMES investigation found little publicly available evidence that several of the statutory mechanisms operated as intended during the period under review, even as donor-supported community services began disappearing in both states.
The findings raise a critical question: if institutions specifically created to sustain the HIV response are not fully functional before donors leave, what happens when external funding eventually disappears?
The council that should lead HIV response
In Akwa Ibom, the HIV/AIDS Control Agency Law establishes the State Council on HIV/AIDS as the highest policy-making body responsible for coordinating the state’s HIV response.
Its composition reflects the importance attached to the epidemic. The governor chairs the council, while the deputy governor serves as vice-chairperson. Other members include the Secretary to the State Government, the Head of Service, commissioners from key ministries and the Director-General of the State Agency for the Control of AIDS (SACA).
Under the law, the council is responsible for providing political leadership, mobilising funding, coordinating partnerships, reviewing implementation of the state’s HIV strategic plan and ensuring that the response remains effective.
The law requires the council to meet at least once every quarter.
Yet, despite repeated requests, the Akwa Ibom government did not provide PREMIUM TIMES with records showing how many statutory meetings were held between January 2023 and June 2026, the resolutions reached at those meetings, or actions taken to prepare the state for declining international donor support.
PREMIUM TIMES also reviewed official government websites, social media pages, publications, press releases and other publicly available records but found no evidence of quarterly council meetings on HIV during the period.
When asked whether the statutory meetings had taken place, Commissioner for Health Ekem Emmanuel said Governor Umo Eno “holds meetings on HIV/AIDS” but referred questions about the number of meetings and records of deliberations to the State Agency for the Control of AIDS.
The commissioner later said he could not be expected to keep track of such meetings.
“You honestly think I will be keeping count of the meetings? I was not the Commissioner for Health in 2023,” he said.
On 7 July, PREMIUM TIMES sent a detailed 12-point enquiry to the agency’s Programme Manager, Enobong Akpan, seeking records of council meetings, budget releases, implementation of the HIV law and the state’s preparedness for shrinking donor support.
Mr Akpan acknowledged receiving the enquiry and initially promised to respond after returning to Akwa Ibom from an official meeting. Despite repeated reminders, he did not respond to the questions.
Missing grassroots structures
Akwa Ibom’s HIV law extends beyond state-level governance. It establishes Local Action Committees on HIV/AIDS across all 31 local government areas, with council chairpersons expected to lead HIV coordination at the local level.
The committees are designed to mobilise communities, coordinate prevention and treatment activities, strengthen awareness campaigns and receive financial support through local government budgets.
Effectively, they are intended to ensure that the HIV response reaches communities long before patients arrive at hospitals or clinics.
However, interviews conducted by PREMIUM TIMES with officials of the Network of People Living with HIV/AIDS in Nigeria (NEPWHAN) in Akwa Ibom, community advocates and local government stakeholders found no evidence that the committees were actively performing those statutory roles.
“We have tried engaging local governments, particularly in areas with high HIV prevalence, but the response has been poor,” Elizabeth Udo, Akwa Ibom State Coordinator of NEPWHAN, told PREMIUM TIMES.
PREMIUM TIMES also could not independently identify recent HIV interventions directly implemented by any of the state’s 31 local governments under the framework created by the law.
Scrutiny of local government spending is further complicated by the 31 councils’ failure to publish their budgets and other fiscal documents, a practice PREMIUM TIMES previously reported to violate the state’s fiscal responsibility law.
The situation in Rivers is similarly unclear.
The Rivers State Agency for the Control of AIDS Law establishes governance structures intended to sustain political commitment, mobilise domestic financing and coordinate the HIV response through a Governor’s Committee on AIDS, a State Council on HIV/AIDS and Local Government Action Committees.
Those institutions were expected to become increasingly important as donor support declined.
However, when PREMIUM TIMES requested records on 7 July showing whether the statutory structures remained functional during the donor transition period, the Rivers State Agency for the Control of AIDS did not respond.
Its Programme Manager, Naaziga Francis, initially indicated that he preferred an in-person interview. But when a PREMIUM TIMES reporter travelled to the agency’s office in Port Harcourt, Mr Francis declined to answer the questions.
“I am just a civil servant. Those questions you have asked will have political consequences,” he said.
PREMIUM TIMES also visited the Rivers State Ministry of Health. Officials explained that the prolonged political crisis in the state meant no commissioner had been appointed, while the permanent secretary had retired.
Repeated telephone calls, text messages and WhatsApp messages sent to the state’s Commissioner for Information, Honour Sirawoo, were not answered before publication.
Law still waiting for assent
Beyond questions about governance and financing, another layer of protection remains incomplete.
Across Nigeria, fear of discrimination continues to discourage some people from testing for HIV, disclosing their status or remaining in treatment.
Although the National HIV and AIDS Anti-Discrimination Act prohib
Akwa Ibom has attempted to enact such legislation for years.
The State House of Assembly first passed an HIV Anti-Stigma Bill in 2021. Despite repeated calls for then-Governor Udom Emmanuel to sign it, the bill lapsed after failing to receive gubernatorial assent before the Assembly completed its tenure.
Lawmakers passed the legislation again in September 2024, but nearly two years later, it still awaits the governor’s assent.
For people like Grace, Mercy, Victoria and Peter, whose experiences are at the centre of this investigation, the delay represents more than legislative bureaucracy. They say it prolongs an environment in which people living with HIV continue to experience discrimination in workplaces, families and communities.
Ms Udo said NEPWHAN members continue to report workplace discrimination, family rejection, denial of inheritance and gender-based violence linked to their HIV status.
“The government should urgently assent to the anti-stigma law,” she said.
“We should not continue relying on the United States alone for HIV response while neglecting the legal protections that encourage people to seek treatment without fear.”
Rivers State has yet to enact a similar anti-stigma law, although its annual budgets have included provisions for the legislative process.
According to Lawyers Alert, a legal and human rights organisation that provides legal services to vulnerable populations, including people living with HIV, the absence of enforceable state legislation weakens both public health and human rights protections.
Its Legal Adviser, Peace Okesola, said fear of discrimination discourages some people from taking HIV tests, disclosing their status, commencing treatment early or remaining in care.
“The enactment and implementation of HIV anti-stigma laws are not merely legislative exercises; they are essential public health and human rights interventions,” the organisation told PREMIUM TIMES.
Assembly promises oversight
The Chairman of the Akwa Ibom House of Assembly Committee on Health, Moses Essien, told PREMIUM TIMES that the legislature had fulfilled its constitutional responsibility by appropriating funds for the HIV response.
“The House of Assembly has exercised its constitutional power by making adequate financial appropriations in the budget for HIV/AIDS,” he said.
“Release of funds is for the appropriate agency to apply for.”
He said lawmakers had not received any formal report indicating that approved funds were withheld.
Regarding concerns about whether the State Council on HIV/AIDS had met as required by law, Mr Essien said the committee would engage the State Agency for the Control of AIDS later this year.
“We will surely direct adherence to regulations covering the agency,” he said.
On the unsigned HIV Anti-Stigma Bill, Mr Essien, who sponsored the legislation, said he recently reminded Deputy Governor Akon Eyakenyi to bring it to the governor’s attention.
He disagreed with suggestions that the Local Action Committees on HIV/AIDS were inactive.
“I won’t subscribe to the committee’s inactivity because I am aware of steps taken by SACA regarding the functionality of all committees,” he said.
He added that Akwa Ibom had established a Local Resource Mobilisation Committee, headed by former Speaker Sam Ikon, to explore domestic financing options as donor support declines.
“As an Assembly that is concerned with the welfare of our people, we will make more budgetary provisions for HIV/AIDS in the next budget,” he added.
Beyond budgets, behind every statistic
The unanswered questions at the heart of this investigation extend beyond government paperwork.
Why were HIV appropriations identified by PREMIUM TIMES not reflected in available budget implementation records? Have the statutory governance structures established under state laws been operating as required? What concrete measures have Rivers and Akwa Ibom taken to sustain HIV services as donor funding declines? And how will the governments finance community-based interventions that patients and advocates say have disappeared?
For people living with HIV, these are not abstract questions of governance.
They determine whether a missed clinic appointment triggers a follow-up phone call, whether medicines reach patients who are too afraid to be seen at HIV clinics, whether newly diagnosed adolescents find support instead of isolation, and whether decades of progress against one of Nigeria’s most persistent public health challenges can survive a changing funding landscape.
Across the three parts of this investigation, PREMIUM TIMES found a widening gap between the structures established to sustain the HIV response and the experiences of people who depend on them.
Budgets reviewed by PREMIUM TIMES show that funds were appropriated. Laws enacted by both states created institutions intended to provide political leadership, sustainable financing and community coordination. Government officials insist efforts are being made.
Yet critical questions about implementation, accountability and preparedness remain unanswered.
Grace’s family still remembers a woman who fought to preserve her dignity until she believed the system created to protect her had failed her.
Her story, and those of countless others, point to the human cost of that uncertainty. Behind every unaccounted-for appropriation, delayed anti-stigma law and unanswered question about statutory institutions are people whose survival depends not only on antiretroviral medicines, but also on governments fulfilling the responsibilities they have already written into law.
Editor’s Note: *The names marked with asterisks have been changed to protect the privacy and identities of vulnerable individuals featured in this report.
This reporting was supported by the Centre for Journalism Innovation and Development (CJID).
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Nearly 11 years after the adoption of the Paris Agreement, world leaders are preparing for another round of climate negotiations amid growing concerns that global commitments are not translating into action quickly enough to address the climate crisis.
The 31st Conference of the Parties (COP31) to the United Nations Framework Convention on Climate Change (UNFCCC), scheduled for 9 to 20 November in Antalya, Türkiye, will bring together governments, climate scientists, development institutions, businesses and civil society organisations to negotiate the next steps in the global response to climate change.
The summit comes at a critical time, as countries face increasing pressure to reduce greenhouse gas emissions, accelerate investment in clean energy and protect communities already experiencing the effects of rising temperatures.
Yet some of the most difficult questions in international climate negotiations remain unresolved.
Who should pay for climate action? How quickly should countries move away from fossil fuels? And how can developing economies pursue economic growth while reducing emissions and protecting vulnerable populations?
These questions are particularly important for Nigeria and other African countries, where the consequences of climate change are becoming increasingly visible through flooding, drought, extreme heat and pressure on agricultural production.
Beyond the environmental consequences, the negotiations have implications for electricity access, public health, food security, employment and the ability of developing countries to attract investment in cleaner technologies.
COP31 is not expected to produce a single agreement comparable to the Paris Agreement. Instead, much of the work will centre on implementing existing commitments, resolving disagreements carried over from previous conferences and establishing clearer pathways for financing climate action.
The central test will be whether countries can move beyond repeated declarations and agree on practical measures that deliver measurable results.
An unusual leadership arrangement
One distinctive feature of COP31 is the arrangement between Türkiye and Australia, which will share responsibilities for organising and leading the conference.
Türkiye will host the summit, with its Minister of Environment, Urbanisation and Climate Change, Murat Kurum, serving as COP president. Australia’s Minister for Climate Change and Energy, Chris Bowen, will serve as president of negotiations.
The arrangement followed a compromise after both countries pursued competing bids to host the conference.
Under the agreement, Türkiye will oversee the presidency and action agenda, while Australia will lead the formal negotiations.
The partnership is significant because the two countries approach climate policy from different economic positions.
Türkiye is an emerging economy seeking to expand industrial development and energy security, while Australia is a developed economy with substantial fossil fuel production and exports.
Their leadership will therefore be tested by the same disagreements that have complicated previous climate summits, particularly those concerning fossil fuels, climate finance and the responsibilities of developed and developing countries.
The Turkish presidency has placed implementation, electrification, green industrial development and resilient infrastructure among its priorities.
One of its flagship initiatives is the 35-by-35 Global Electrification Pledge, which seeks to increase electricity’s share of global final energy consumption to 35 per cent by 2035, from just over 20 per cent.
The initiative is intended to encourage greater use of electricity in transport, buildings and industry, supported by cleaner power generation, modern electricity grids and energy storage.
However, the pledge forms part of the presidency’s voluntary action agenda rather than a binding agreement negotiated by all countries.
This distinction matters because announcements made by summit organisers do not automatically become obligations under the UN climate process.
The World Leaders Climate Action Summit, scheduled for 11 and 12 November, will provide an early indication of the political support available for these priorities.
The finance question remains unresolved
Climate finance is likely to be among the most contentious issues in Antalya.
Developing countries have long argued that they cannot be expected to reduce emissions and adapt to climate impacts without substantial financial support from wealthier nations, which bear greater historical responsibility for greenhouse gas emissions. This principle is reflected in Article 9 of the Paris Agreement, which requires developed countries to provide financial resources to support developing countries’ mitigation and adaptation efforts.
At COP29 in Baku, Azerbaijan, in 2024, countries agreed that developed nations should take the lead in mobilising at least $300 billion annually in climate finance for developing countries by 2035. The agreement also called for efforts to scale up finance from all public and private sources to at least $1.3 trillion annually by the same year.
The two figures are not interchangeable. The $300 billion target is the new collective finance goal led by developed countries, while the wider $1.3 trillion ambition is expected to draw on a broader range of sources, including private investment.
For developing countries, the concern is whether the money will be available on affordable terms and reach the communities and sectors most exposed to climate risks.
A major disagreement concerns the responsibility of developed countries to provide financial resources under the Paris Agreement.
Developing countries want discussions to address these obligations, particularly the provision of public finance. Some wealthier countries favour a broader approach that includes improving access to finance and expanding the range of contributors.
For Nigeria, the funding needs are substantial.
The country requires investment in renewable energy, electricity infrastructure, climate-resilient agriculture, flood management and early-warning systems. Many of these interventions will depend on concessional finance and public investment, rather than private capital alone.
The question at COP31 will be whether countries can make progress on the scale, quality and accessibility of climate finance, rather than simply restating funding ambitions.
Fossil fuels and the just transition
The future of fossil fuels will also remain a difficult issue.
At COP28 in Dubai in 2023, countries agreed for the first time in a final climate decision to transition away from fossil fuels in energy systems in a just, orderly and equitable manner. The agreement also called for tripling global renewable energy capacity and doubling the rate of energy-efficiency improvements by 2030.
The decision marked a significant shift in climate negotiations. However, countries have continued to disagree over how to implement it, and the commitment has yet to translate into an agreed global roadmap for moving away from coal, oil and gas.
At COP30 in Belém, Brazil, in 2025, countries failed to secure a formal roadmap for the transition away from fossil fuels. The omission exposed the continuing divide between nations seeking faster action and those whose economies depend heavily on fossil fuel production.
The issue is particularly sensitive for Nigeria, where oil and gas remain important sources of government revenue and foreign exchange. At the same time, millions of people lack reliable electricity, while gas flaring, pollution and energy poverty continue to affect communities.
A transition that ignores these realities risks deepening existing inequalities. But maintaining dependence on fossil fuels without a credible plan for cleaner energy also exposes the country to economic and environmental risks as the global energy system changes.
This is where the just transition mechanism agreed at COP30 becomes important. Countries are expected to discuss its structure and implementation at COP31.
The mechanism is intended to strengthen international cooperation, technical assistance and capacity-building to help countries and workers navigate the shift to lower-carbon economies.
For Nigeria, a meaningful just transition must go beyond replacing one energy source with another. It should address the affordability and reliability of electricity, the future of workers in fossil fuel-dependent industries, the development of local clean-energy businesses and the needs of communities affected by environmental degradation.
Adaptation cannot wait
While emissions reduction receives considerable attention at climate summits, adaptation is equally urgent for countries already experiencing the effects of climate change.
Flooding, prolonged dry spells and rising temperatures are affecting livelihoods and infrastructure across Africa. In Nigeria, recurring floods have displaced communities, damaged homes and farms, disrupted transport and increased pressure on public services.
The effects extend beyond physical damage.
Extreme heat can affect workers’ productivity and health, while disruptions to agricultural production can worsen food insecurity. Poorer households often have fewer resources to recover from these shocks.
At COP30, countries agreed on 59 indicators to help measure progress towards the Global Goal on Adaptation. The indicators are intended to assess how countries are strengthening resilience in areas such as water, food systems, health and infrastructure.
However, agreeing on indicators does not automatically provide the resources needed to implement adaptation plans. Developing countries continue to demand more predictable funding, particularly for projects that may not attract private investment.
COP30 also called for efforts to at least triple adaptation finance by 2035. Questions remain over how the commitment will be measured and delivered.
Nigeria’s climate ambitions
Nigeria will arrive in Antalya with an updated climate commitment that sets out a more specific emissions-reduction pathway.
Under its third Nationally Determined Contribution (NDC 3.0), submitted in 2025, Nigeria targets an absolute emissions reduction of 168.2 million tonnes of carbon dioxide equivalent by 2030 and 184.9 million tonnes by 2035, using 2018 as its base year. These targets represent reductions of about 29 and 32 per cent, respectively, against the country’s 2018 net emissions. Nigeria also maintains its ambition to achieve net-zero emissions by 2060.
The plan includes commitments for the energy, industrial, agriculture, land-use and waste sectors. For the oil and gas industry, it targets zero routine gas flaring by 2030, alongside reductions in fugitive emissions from leaks and venting.
But the challenge is turning these commitments into functioning projects and measurable results.
Achieving these targets will require sustained investment in renewable energy, stronger electricity infrastructure, effective regulation and better coordination among government agencies and private investors.
This is particularly relevant to COP31’s proposed 35-by-35 electrification target.
A narrowing window for climate action
COP31 also comes as the international community prepares for the second Global Stocktake under the Paris Agreement, the process through which countries assess collective progress towards the treaty’s goals.
The first stocktake, concluded in 2023, found that global efforts were insufficient to keep the world on track to limit warming to 1.5 degrees Celsius above pre-industrial levels. Its outcome called for faster action on renewable energy, energy efficiency, deforestation and the transition away from fossil fuels.
The latest United Nations Environment Programme Emissions Gap Report reinforces the urgency. It warns that global temperatures are expected to exceed the 1.5-degree threshold, even as it argues that the scale and duration of that overshoot can still be limited through faster emissions cuts.
The report estimates that current national climate pledges, if fully implemented, would reduce emissions by only 11 to 15 per cent by 2035 compared with 2025 levels. A pathway designed to return global temperatures to 1.5 degrees by the end of the century would require emissions to fall by 45 per cent by 2035.
The United States’ absence from the official government delegation will also be notable.
The country formally withdrew from the Paris Agreement in January 2026, presenting another challenge to international cooperation at a time when stronger action from major emitters is needed.
Ultimately, the significance of COP31 will not be measured by the number of speeches, announcements or pledges made in Antalya. It will depend on whether countries can resolve outstanding disagreements, strengthen support for vulnerable nations and establish practical pathways for delivering commitments already on the table.
For Nigeria, the summit should be more than an opportunity to restate its climate ambitions. It is a chance to push for accessible finance, strengthen the case for investment in clean energy and ensure that the transition supports jobs, electricity access and livelihoods.
This report is published as part of the COP31 Reporting Fellowship of the Centre for Journalism Innovation and Development
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Health
Plateau Mega Medical Outreach Treats 17,603 Patients, Performs 724 Surgeries Across Three Zones
The Plateau State Government says its free Mega Medical Outreach has attended to 17,603 patients and performed 724 surgical operations across the three senatorial zones, significantly exceeding its initial target of 6,000 beneficiaries.
The Commissioner for Health, Dr Nicholas Baamlong, disclosed this on Saturday, November 7, 2026, while briefing journalists on the conclusion of the general phase of the exercise organised by Governor Caleb Mutfwang.
According to Baamlong, the outreach, which ran from October 19 to November 6, covered selected public health facilities across the Central, Southern and Northern Senatorial Zones, providing free consultations, laboratory investigations, eye care, dental services and major and minor surgical procedures successfully carried out with no deaths.
The figures released by the Ministry of Health show that the programme attended to 4,294 patients in the Central Zone, 5,625 in the Southern Zone and 7,684 in the Northern Zone.
Across the three zones, the government recorded 5,033 eye consultations, distributed 3,588 pairs of eyeglasses and performed 390 cataract surgeries. A total of 4,857 laboratory investigations and 1,334 dental consultations were also conducted.
The outreach further recorded 724 surgical operations, comprising 151 major and 573 minor surgeries. The procedures included myomectomies, hysterectomies, prostatectomies, thyroidectomies, caesarean sections and orthopaedic interventions.
The ministry also disclosed that 457 people were enrolled in the Plateau State Contributory Healthcare Management Agency (PLASCHEMA) during the exercise.
Baamlong said the 17,603 beneficiaries represented approximately 193 per cent above the initial target, describing the turnout as evidence of the demand for accessible and affordable healthcare services in the state.
However, the commissioner acknowledged that the outreach should not be treated as an isolated intervention, stressing the need to strengthen healthcare delivery across primary, secondary and tertiary health facilities.
He disclosed that Governor Mutfwang intends to institutionalise the programme as a regular intervention rather than a one-off exercise, dismissing suggestions that it was organised primarily because of the approaching election.
According to him, the programme had been planned earlier in the year but was delayed by the coordination, planning and engagement required with development partners, including German partners.
He explained that while emergency interventions, outbreak responses and ambulance services remain part of the ministry’s activities, the medical outreach is another component of the government’s broader healthcare strategy.
The commissioner said the long-term objective should be to strengthen existing health institutions to the point where elaborate medical outreaches would no longer be necessary, while ensuring that residents have regular access to essential healthcare services.
The programme is, however, not yet entirely concluded, as the government announced another three-week phase of specialised medical interventions at Plateau State Specialist Hospital, Jos, Jos University Teaching Hospital (JUTH) and Potters Specialist Hospital, Jos.
The next phase is expected to cover advanced orthopaedic, neurological, neurosurgical, urological and ear, nose and throat (ENT) surgeries for patients requiring more complex medical procedures.
The Permanent Secretary of the Ministry of Health, Mr Samuel Aliyu Tsoho, said the intervention cost millions of naira, while appreciating the governor, medical personnel and other stakeholders who participated in the exercise.
He particularly acknowledged health workers who travelled to rural communities and remained at designated facilities to provide services throughout the outreach.
While the government has presented the figures as a major achievement, the planned institutionalisation of the programme raises an important question about the sustainability of free medical interventions and the capacity of existing public health facilities to provide affordable services beyond periodic government-sponsored outreaches.
For thousands of residents who benefited from the exercise, the intervention provided access to treatments and surgeries that might otherwise have been financially difficult to afford. The challenge now is to translate the intervention into lasting improvements in healthcare access, infrastructure and service delivery across Plateau State.
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