Breaking the wall of silence: AIDS policy and politics in Nigeria.

AIDS was first diagnosed in Nigeria in 1986. By that time, the government had enough information from experiences in other African countries to goad it into quickly establishing a control program. Nigeria's National AIDS Control program, however, fell victim to years of military arbitrariness and uncertainty. It was underfunded and had three directors in as many years. This arbitrariness and general lukewarm response from government occurred despite rapid increases in seroprevalence rates. Available data indicate a national prevalence of 5.4 percent and rates as high as 30 percent among some "high-risk" groups; as many as 10 to 15 persons with full-blown AIDS are admitted weekly in some tertiary facilities. Experiences in communities show an already heavy and growing burden. The nonchalance of past military regimes is gradually being reversed with Nigeria's return to civil rule in May 1999. Perhaps because of the fragmented statistics and the government's seeming conspiracy of silence, Nigeria is not included in the count of African countries with high HIV/AIDS prevalence. The author suggests that the new democratic government needs to go beyond professed commitment to demonstrable action to halt the spread and address social and other impacts of the epidemic.